Uterine Fibroid Embolization

The Division of Interventional Radiology is proud to provide uterine fibroid embolization services for treatment of symptomatic uterine fibroids for the Southcoast Hospital System.

Introduction to Uterine Fibroids

Fibroids are benign (non-cancerous) tumors made up of smooth muscle cells and connective tissue that grow in the wall of the uterus.
They appear after puberty and can grow over time, but often decrease in size after menopause.
Fibroids can cause symptoms such as heavy menstrual bleeding, urinary frequency, pelvic pain/cramping, and painful intercourse.

Fibroid Treatment Options

Uterine fibroids can be treated with hormonal therapy, surgery (myomectomy or hysterectomy), or by a minimally-invasive procedure known as a uterine fibroid embolization (UFE), which is performed by an interventional radiologist.

What is an Interventional Radiologist? (learn more)

Interventional Radiologists (IR doctors) are physicians who perform minimally-invasive procedures in nearly every organ system of the body using ultrasound, x-ray, CT, or MRI guidance.
By performing procedures in the least invasive way possible, interventional radiologists can diagnose, treat, and even cure disease while minimizing the risk to the patient and improving health outcomes with less pain and shorter recovery times in comparison to open surgery.
Most procedures can be performed without the need for general anesthesia or admission to the hospital.

What is Uterine Fibroid Embolization?

Uterine fibroid embolization (UFE) is a minimally-invasive image-guided procedure that has been safely used for over 20 years to treat patient’s with symptomatic uterine fibroids.
It involves blocking the blood supply to the fibroids, which deprives them of oxygen and nutrients and causes them to shrink.

How is the procedure performed?

The procedure itself is not significantly painful and is performed with sedation medicine rather than general anesthesia (no breathing tube).
The procedure is performed by inserting a small catheter/tube into the artery in either the groin or the wrist and advancing it to the blood vessel that supplies the fibroids.
Once the catheter is in position, the blood vessel is blocked (embolized) by injecting small particles/beads through the catheter.

Recovery after UFE

Patient’s have the option of being discharged home on the day of the procedure; however, most prefer to be observed overnight for pain control and nausea management.
As the fibroids degenerate, inflammatory mediators are released that cause a variety of symptoms known as post-embolization syndrome (PES).
All patients experience some degree of PES.
PES symptoms include crampy pelvic pain, nausea, vomiting, fever, and malaise.
These symptoms typically peak in 12-24 hours and resolve within 5-7 days.

Is UFE safe and what are the risks?

Uterine fibroid embolization is a relatively safe procedure with a lower complication rate than surgery (myomectomy or hysterectomy).
The main risks of the procedure include bleeding, infection, injury to blood vessels, and non-target embolization (blocking the blood flow to the wrong blood vessel).
Because the effect on fertility is not fully understood, UFE is typically offered to patients who no longer wish to become pregnant or want to avoid surgery.

What is the benefit of UFE over surgery?

No incision and no need for general anesthesia.
Lower complication rate and shorter recovery time in comparison to surgery.
Surgery is still an option if symptoms persist after UFE.

How effective is UFE?

Symptomatic improvement following uterine fibroid embolization has been reported to be 80% to 95%.
Fibroids have been shown to decrease in size by up to 50% within six months of the procedure.

What is required before I can have a UFE?

Prior to having a UFE, patients will need to be evaluated by a Gynecologist to confirm that they are an appropriate candidate.
An endometrial biopsy will need to be performed to rule out an underlying cancer.
Patients will also require an MRI for planning purposes and to assess the size, location, and number of fibroids.

Follow-up after UFE

Patients are evaluated in the IR clinic 4 weeks after the procedure and again at 6 months where they will also have a follow-up MRI.