Uterine Fibroid Embolization (UFE) is a minimally invasive, non-surgical treatment for symptomatic uterine fibroids. Performed by an interventional radiologist, the procedure addresses the growths that develop from the muscular tissue of the uterus. The primary goal of UFE is to block the blood supply to the fibroids, causing them to shrink and reduce symptoms over time. This approach offers a less invasive alternative to major surgical procedures like hysterectomy or myomectomy.
The Procedure and Patient Suitability
The UFE procedure begins with the patient receiving a sedative, and a local anesthetic is applied to the puncture site, typically in the groin. An interventional radiologist then inserts a thin, flexible catheter into the femoral artery through a small incision. Using specialized X-ray guidance (fluoroscopy), the catheter is carefully navigated until it reaches the uterine arteries supplying the fibroids.
Once positioned, the radiologist injects tiny embolic agents—particles about the size of sand grains—into the blood vessels feeding the fibroids. These particles lodge in the vessels, effectively blocking the blood flow and causing the fibroid tissue to die and shrink. The process is repeated for the arteries on the other side of the uterus to ensure all target vessels are blocked.
Ideal candidates are women suffering from symptomatic fibroids, such as those experiencing heavy menstrual bleeding or pelvic pressure, who wish to preserve their uterus. The procedure is suited for women who want to avoid major surgery and its longer recovery period. Contraindications include active pelvic infection, known or suspected malignancy, and current pregnancy.
Immediate Recovery and Aftercare
The immediate recovery is marked by a period of intense discomfort, which is an expected consequence of the fibroids losing their blood supply. Most patients experience significant pelvic pain and cramping within the first 12 to 24 hours. This pain requires management with prescription narcotic medication, which is the main reason patients often stay in the hospital for observation, typically overnight.
A common reaction following the procedure is known as postembolization syndrome, which can include low-grade fever, fatigue, nausea, and general discomfort. The mild fever should not exceed 101 degrees Fahrenheit and is managed with anti-inflammatory medication. Anti-nausea medication is provided for nausea, which is a frequent side effect.
Patients can expect vaginal discharge (clear, brown, or grayish) that may persist for several weeks or even months as the body processes the dying fibroid tissue. While some individuals may return to light daily activities within a few days, a full return to normal routines and work typically takes between one and two weeks. Strenuous activity and heavy lifting, defined as over 10 pounds, should be avoided for at least the first week to prevent complications at the access site.
Long-Term Results and Symptom Improvement
The goal of UFE is to achieve long-term control over fibroid-related symptoms, with most patients reporting significant or complete relief. Patient satisfaction rates are frequently reported in the range of 85% to 90%. The most noticeable improvements are typically seen in heavy menstrual bleeding (menorrhagia) and pelvic pressure or pain.
Symptom relief is not immediate; it occurs gradually as the embolized fibroids shrink and soften. Significant reduction in heavy bleeding is often noted within the first few menstrual cycles. Bulk-related symptoms, such as pressure, may take three to six months to fully improve. Studies show that fibroids can shrink in volume by an average of 42% to 83% within six months following the procedure.
Long-term success is measured by sustained improvement in quality of life and the avoidance of further intervention. The likelihood of needing a repeat procedure or a hysterectomy years after UFE is relatively low. UFE provides an effective and durable solution for managing fibroid symptoms.
Potential Complications
While UFE is considered a low-risk procedure, there are specific adverse events that differ from the expected post-operative discomfort. Infection is a risk, particularly in the embolized fibroid tissue, with a reported rate of around 2%. To mitigate this risk, patients typically receive antibiotics before and after the procedure.
There is a small chance of premature menopause or the loss of menstrual periods, which occurs more frequently in women over the age of 45. This complication is estimated to affect between 1% and 5% of women undergoing the procedure. Risks related to the catheterization process include injury to the artery or a hematoma at the puncture site.
A rare but serious risk involves the embolic agents migrating to non-target organs, which could potentially damage surrounding tissues. The impact of UFE on future fertility and pregnancy outcomes is still a subject of ongoing research, and this factor should be thoroughly discussed with a healthcare provider before treatment.