Uterine fibroid embolization

Uterine fibroid embolization (UFE) is a minimally invasive treatment for tumors (growths of tissue) on the wall of your uterus. Fibroids, also called myomas, are usually benign (not cancerous), but they can cause pain, heavy menstrual bleeding, and other symptoms that affect your quality of life.

UFE is a nonsurgical procedure that blocks blood flow to the fibroids, causing them to shrink. It’s an alternative to major surgery such as hysterectomy (surgery to remove the uterus) or myomectomy (surgery to remove fibroids).

During UFE, an interventional radiologist makes a small needle puncture in your groin (upper leg). They insert a catheter (thin, flexible tube) into your femoral artery, the main blood vessel delivering blood to your lower body. A type of X-ray technology called fluoroscopy produces video images of your blood vessels to guide your doctor during the procedure.

The catheter is threaded through blood vessels until it reaches the arteries that supply blood to your uterus and fibroids. The interventional radiologist injects an embolic agent into these arteries that blocks blood to the fibroids. The embolic agent may be microscopic beads, gelatinous foam, or a sand-like material. Without a blood supply, the fibroids shrink over time.

Uterine fibroid embolization is one treatment for fibroids. The right treatment for you will depend on many factors, including your age, symptoms, the size and location of the fibroids, and whether you want to get pregnant in the future. Embolization can affect fertility, so it’s an important conversation to have with your health-care provider.

Uterine fibroid embolization is very effective, helping to relieve symptoms for about 90 percent of women who have the procedure. It offers a variety of benefits over surgery, including:

• Faster recovery
• Less pain
• Lower risk of complications
• No hospitalization

Up to 80 percent of women develop uterine fibroids by the age of 50. Many women don’t have symptoms. But for others, fibroids can make it hard to enjoy life and do everyday activities.

Uterine fibroid symptoms aren’t just a normal part of aging that you must accept—treatments are available. Talk to your health-care provider if you have:

• An enlarged abdomen
• Anemia (low red blood cell count) and fatigue
• Bloating or constipation
• Difficulty getting pregnant
• Frequent urination and other bladder problems
• Heavy menstrual bleeding, long or painful periods, or bleeding between periods
• Lower back or leg pain
• Pain during sexual intercourse
• Pain or pressure in your pelvis or rectum

We may do imaging exams such as an ultrasound or MRI before uterine fibroid embolization. These tests help us evaluate the fibroids, locate the uterine arteries, and plan treatment.

We may ask you to stop taking certain medications, such as blood thinners, several days before embolization. You can continue taking birth control pills or other hormonal treatments that ease fibroid symptoms. Your health-care provider will tell you when it’s safe to stop these medications after your procedure.

An interventional radiologist performs embolization in an operating room or catheterization lab. The procedure can take anywhere from one to three hours.

During fibroid embolization, here’s what you can expect:

1. We connect you to machines that monitor your breathing, blood pressure, temperature, and heart rate.
2. A nurse applies an anesthetic to your upper leg to prevent pain.
3. You receive a sedative through a vein in your arm. You’ll feel sleepy and relaxed.
4. The interventional radiologist makes a small cut in your skin and inserts a catheter into your femoral artery.
5. They inject a contrast dye into your bloodstream so your arteries show up in more detail.
6. Using imaging guidance, they advance the catheter to your uterine arteries and inject the embolic agent.
7. The interventional radiologist repeats the process with other uterine arteries as needed.
8. They make sure blood flow to the fibroids has stopped.
9. We remove the catheter and place a bandage over the puncture site.

Uterine fibroid embolization is usually an outpatient procedure, so you don’t stay overnight in the hospital. You may have pelvic pain, cramping, and pressure for the first few days after treatment. Some people also have flu-like symptoms such as fever, chills, and fatigue. You’ll receive medication to control pain and ease nausea. It typically takes a week to 10 days to recover from embolization. At that time, you can return to your normal activities.

Your first period after the procedure may be heavier or more uncomfortable than usual. You may also notice bleeding between periods for the first few weeks. Your symptoms should improve after about three months. Fibroids continue to shrink for six to nine months or longer.

Complications from uterine fibroid embolization aren’t common, but they can include:

• Allergic reaction to contrast dye
• Blocked blood flow to healthy tissue (if the embolic agent lodges in the wrong place)
• Blood vessel damage
• Excessive bleeding
• Fibroid expulsion (when fibroids completely or partially pass out of your body through your vagina)
• Infection

Our expertise in all areas of women’s health, gynecology, and interventional radiology means you’ll find effective care from top specialists, no matter your concern. We offer:

• Personalized care: At the Penn Center for Integrated Fibroid Care, you receive treatments tailored to your needs, preferences, and future goals. We take the time to find out how fibroids are affecting your life and provide a safe, compassionate environment where you can feel comfortable.
• Collaborative approach: Interventional radiologists, gynecologic surgeons, fertility specialists, and other experts work together to plan your treatment. And no matter where you receive care, you can count on the renowned resources and capabilities of Penn Medicine.
• Minimally invasive options: We offer a range of ways to relieve fibroid symptoms without major surgery. In addition to embolization, we specialize in laparoscopic and robotic-assisted surgery and radiofrequency ablation. You recover with less pain and downtime so you can enjoy life again.