Uterine Fibroid Embolization

Uterine fibroid embolization (UFE) is a relatively new treatment for benign tumors (fibroids) that grow in or on the uterus. UFE works by blocking the blood supply to the fibroid, causing it to shrink and become inactive.

There are several types of fibroids. Subserosal fibroids may have an increased risk of complications from UFE.

Unlike other treatment methods for uterine fibroids that may cause side effects or require an extended hospital stay, UFE is a minimally invasive procedure that requires a relatively short recovery time and has few side effects.

UFE is still somewhat controversial, since long-term outcomes of the procedure have not been determined. While most insurance companies cover the procedure, some still do not.

The procedure is not recommended for all women. Physicians typically require that candidates meet the following criteria:

Have completed childbearing
Have not gone through menopause
Have symptomatic uterine fibroids, with excessive or prolonged bleeding, pain, urinary frequency or urgency, or loss of bladder control
Have a strong desire to avoid a hysterectomy

THE PROCEDURE

Prior to the procedure, intravenous antibiotics and a sedative are given to the patient; and a local anesthetic is administered to numb the groin area. During the procedure, which is viewed by an x-ray technique called fluoroscopy, an interventional radiologist inserts a needle into the femoral artery, providing access for a catheter to be guided to the uterine artery. The interventional radiologist then injects a dye into the artery to view the blood supply to the fibroids. This technique, called an arteriogram, provides a "map" of the blood supply. Once the interventional radiologist completes the arteriogram, synthetic particles the size of grains of sand are slowly injected into the artery. The particles flow toward the fibroids and wedge in the vessels that supply them with blood. This procedure, called embolization, continues for several minutes until there is blockage of blood flow to the fibroids. The procedure takes approximately one hour.

POST PROCEDURE

Following the procedure, the patient may expect:

A one-night hospital stay
6 to 12 hours of pronounced cramping (treated with oral or intravenous medications)
Possible cramps that may last one week
Fever and nausea
Full recovery in one week

SIDE EFFECTS

Fever and fatigue are the expected side effects during the first week. Complications affect fewer than four percent of patients, and serious complications are very rare. The procedure may pose long-term complications that make childbearing or full-term pregnancy difficult. Women who have undergone UFE have had successful pregnancies, but long-term studies are limited and information is lacking on this subject.