Interventional Radiology: Uterus / Gynecologic
Uterine Fibroid Embolization

Also called: Uterine artery embolization (UAE)

Uterine fibroid embolization (UFE) procedures can provide an effective alternative to surgery or hormonal therapy for the treatment of symptomatic uterine fibroid tumors. Fibroids are common non-cancerous growths that develop in the walls of the uterus. The size and location of fibroids can lead to problems for some women including pain, heavy bleeding and urinary frequency. Hormonal therapy, myomectomy (surgical removal of fibroids) and hysterectomy (surgical removal of the uterus) are the most common treatment options.

UFE is usually performed after a thorough pre-procedural evaluation by a gynecologist. During this evaluation the diagnosis of fibroids should be confirmed with pelvic / transvaginal ultrasound or pelvic MRI or CT. Other causes for the patient's symptoms must be excluded such as endometriosis, infection and cancer. An appropriate candidate for UFE includes a patient, who has symptomatic fibroids, has been advised to have an invasive fibroid treatment, does not plan on future child bearing (although many have delivered normal babies) and prefers a non-surgical procedure.

Studies show that 78 to 94 percent of women having the procedure experience significant relief or total relief of symptoms. The procedure is effective even when multiple fibroids are involved. No recurrences have occurred in women who have been followed for up to seven years after the procedure.

UFE, performed under conscious / IV sedation, involves placement of a small tube (catheter) in the right femoral artery by an interventional radiologist. For the procedure, a 1/4 inch incision is made in the groin and a catheter is guided under fluoroscopic x-ray to one or both of the uterine arteries. Tiny plastic or gelatin sponge particles are injected into the uterine artery(s) via the catheter. The uterine arteries supply blood to the fibroid tumor(s). The particles cut off the blood flow causing the tumor(s) to shrink overtime. Before the catheter is removed, an angiogram / arteriogram is performed to verify that blood flow to the tumor is occluded.

After the catheter is removed, patients are required to lie flat for 6 hours to promote blood clotting at the puncture site. Fibroid embolization usually requires an overnight hospital stay. Moderate to severe pelvic cramping and low grade fever common for 24 to 72 hours after the procedure, are generally tolerated with oral pain relievers. Recovery takes approximately one to two weeks. For more information see embolization.