Uterine fibroid embolization is a popular treatment for uterine fibroids that generally has very good outcomes.
Uterine fibroid embolization (UFE) is a procedure to treat uterine fibroids. Fibroids are benign uterine tumors that start growing inside the smooth muscle within the walls of the uterus. There can be one or many that grow at the same time.
UFE is also sometimes called uterine artery embolization (UAE), but this term is a bit less specific.
UAE is performed for conditions that cause severe pelvic bleeding. UFE refers only to cases when this procedure is done to treat fibroids.
Fibroids can grow to be the size of a grapefruit or even larger. It’s unclear why fibroids start growing, but they’re quite common. They’re rarely cancerous but can cause symptoms, including:
- heavy periods
- pressure or fullness in the pelvic area
These symptoms may vary from person to person and by fibroid size and location. Similarly, treatment may vary based on symptoms, desire for future pregnancy, location and type.
UFE is one popular treatment option. It’s minimally invasive and proven to be effective. It was first performed in the 1990s, and techniques for the procedure have since been improved.
According to a 2017 study on costs and distributions associated with hysterectomy and UFE, there are approximately
Like any procedure, it may not be the right approach for everyone. Long-term side effects may include changes with fertility and pregnancy, heavier or lighter periods, and fibroid recurrence. In very rare cases, the procedure can cause infection.
Learn more about UFE and its possible side effects below.
UFE is one treatment option for uterine fibroids. It’s most often recommended for people who:
- have symptomatic fibroids
- want to avoid surgery to treat fibroids
- are not planning on getting pregnant in the future
- have already gone through menopause
A steady blood supply “feeds” fibroids, causing them to grow. UFE works by blocking the blood supply to the fibroids, causing them to shrink.
For this procedure, you’ll be under some sort of sedation, or anesthesia. You’ll also be given a local anesthetic before a small cut is made, usually in the groin. A catheter goes into this cut and is directed into the blood vessels that are connected to the fibroids.
From there, a contrast (dye) is pushed into the catheter as part of a fluoroscopy procedure.
Fluoroscopy is similar to an X-ray, but rather than a single image, it shows the doctor what’s happening in real time. The doctor will be guided throughout the procedure by what’s seen on the screen.
Next, a compound made of plastic or gel is delivered through the catheter. This is placed in the blood vessels to block blood from reaching the fibroids.
Without a blood supply, the fibroids should shrink. It can take up to 6 months for the fibroids to shrink, but symptoms tend to improve before then.
Many people have good results with UFE. It’s normal to have some pain and cramping following the procedure. After having UFE, most people are back to a normal routine within a few weeks.
As with any other procedure, there can be long-term side effects. Talk with your doctor if you’re concerned about any of these possible side effects.
Changes with fertility
In some cases, it can be harder to get pregnant after undergoing UFE. There’s possibility of damage to the uterus or ovaries.
A review of studies published in 2018 showed lower rates of pregnancy after UFE than myomectomy (surgery to remove fibroids). Overall, there isn’t a lot of existing research on pregnancy outcomes after UFE.
UFE is often not recommended for people who want to get pregnant in the future.
If you’re hoping to get pregnant in the future, make sure your doctor is aware of your plans. There may be other fibroid treatment options for you to try.
Effects on pregnancy
Some research suggests a
Changes to your menstrual cycle
It’s possible that your periods may be heavier for a few months after UFE. On the other hand, many people who undergo UFE find that their periods end up being lighter if the fibroids were causing heavy menstrual bleeding.
Most cases of fibroids occur before menopause. It’s difficult to know exactly how often treatment with UFE causes early menopause.
According to a
Early menopause can affect heart and bone health. Some people who experience it may need hormone replacement therapy.
Recurrence of fibroids
It’s possible that new fibroids can grow after UFE. If you notice the return or worsening of any symptoms, it’s best to talk with your doctor.
In less than 1 percent of cases, infection can occur in the uterus after UFE. Symptoms include:
- sudden, severe pain
- vaginal discharge and/or bleeding
It’s important to seek treatment quickly if any of these symptoms occur after UFE.
Failure to diagnose a rare cancer
In very rare cases, a type of cancer called leiomyosarcoma can grow in fibroids. UFE treats fibroids, but it doesn’t treat this type of cancer. It’s possible that UFE might cause a delay in diagnosing and treating this cancer.
There’s no easy way to tell between cancer and a fibroid based on only imaging.
After any procedure, it’s important to give yourself time to rest as your body heals. Avoid any heavy lifting for a few weeks. Gentle movement like walking is OK depending on how you’re feeling.
There are some short-term side effects that you may feel after a UFE procedure. For many, they will resolve in a week or two. There are things you can do to feel better while you heal.
Below are some things to be aware of if you undergo UFE.
It’s normal to experience some pain or cramping after UFE.
In the hospital, you may get pain medication through an intravenous (IV) line.
You may be given a prescription for pain medication or advice on using over-the-counter pain medication for when you return home.
There will likely be some discharge after the procedure. You may also pass some fibroid tissue, but this is rare.
Be sure to have some menstrual pads ready for after the procedure and avoid using tampons for a few weeks.
A small cut is made to insert a catheter as part of the procedure. Showers are OK after UFE, but you should avoid soaking in a bath for the first week.
Monitor the site of the cut to make sure it stays clean and dry and talk with your doctor if you see any signs of infection.
It’s possible that being less active and taking pain medications can cause constipation. Drinking more fluids and eating high fiber foods can help. Sources of fiber include:
- whole grains
Your doctor can give you medications if the constipation is not getting better with these steps.
UFE has become a popular treatment option for uterine fibroids.
It generally has very good outcomes and is minimally invasive, with little downtime after it’s performed.
The procedure might affect fertility, pregnancy, and menstruation.
No one procedure will be the right option for everyone. UFE is just one of many treatment options for fibroids. Talk with your doctor about all of your options, and their possible side effects, to find the one that’s best for you.