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Fibroids

Uterine Fibroid Embolization (UFE) Procedure – Questions for Your Doctor

7 Minute Read

By Dr. Mohammad Bilal, Director of Interventional Radiology at Viva Eve

Uterine fibroids are non-cancerous tumors that develop in the uterus. They may also be referred to as myoma, leiomyoma, leiomyomata, and fibromyoma.

These benign tumors develop from normal uterus muscle cells that start growing abnormally. Fibroids can vary in size, ranging from microscopic to several inches. There are several different types of fibroids and it’s not unusual to have more than one type.

Fibroids may or may not cause symptoms. While some women have no symptoms at all, others experience pelvic pain, abdominal swelling and heavy menstrual bleeding. Uterine fibroid embolization is a fibroids treatment that can ease your symptoms without surgery. 

As you’re considering how to treat your uterine fibroids, you obviously want to know the details of all the different options: how to prepare, what to expect during the procedure, and how long the recovery will take.

With uterine fibroid embolization (UFE), it’s no different. You know most of the pros and cons, but you want to know more. Here are some of the questions that my patients ask during UFE consultations. 

1. Why Do You Recommend Uterine Embolization To Your Patients?  

There are various ways to treat fibroids, depending on how many you have, how large they are and where they are located. All have their pros and cons, but for many women UFE is the least invasive, most convenient and most comfortable option. There are many reasons why I think UFE is a good option for the patient who qualifies for the procedure:

  • Very High Success Rate. Over 90% of my patients report a complete or significant resolution of their symptoms. The statistics are similar in other practices and hospitals. 
  • Organ sparing procedure. With UFE, there is no need to remove the uterus, unlike with a hysterectomy. 
  • Outpatient procedure. The patients  are able to go home the same day.
  • Recovery time. Most women can start moderate activity the day after the surgery and can return to their normal activities within a week. With surgical treatments, recovery time can be weeks or even months.
  • Local anesthesia. Unlike surgery for a myomectomy or hysterectomy, UFE is done under moderate anesthesia, which means you will be sleepy during the procedure and feel no pain.
  • Minimal scarring. UFE only requires a small incision and leaves only a tiny scar.
  • Treatment of all fibroids. UFE treats all your fibroids – even those too small to see in a scan – at the same time. This makes UFE a more permanent treatment than hormone therapy, because when you stop drug treatment for fibroids, they usually grow back.
  • No bone loss. Hormone therapy has also been known to lead to osteopenia (the decrease in bone density that can potentially lead to osteoporosis) and other serious side effects, none of which happen with UFE.
  • Cost. UFE is covered by most insurance companies.

The Viva Eve team of fibroid specialists may recommend it if the following is true:

  • You have uterine fibroids that are causing heavy bleeding, severe pain and affecting the quality of life.
  • You are looking for a minimally invasive non surgical option with a quick recovery.
  • You want to keep your uterus.

2. How is Uterine Embolization Performed?

UFE is a minimally invasive procedure performed by an interventional radiologist like myself that takes about an hour. During the procedure, you will be given an IV line with a mild sedative which will provide “twilight” sedation.

The doctor will numb part of your thigh or your wrist and make a tiny incision. Then, using an x-ray camera called a fluoroscope, the interventional radiologist will insert a catheter (thin tube) through the incision and into your femoral artery, which is in your groin area or the radial artery on your wrist.

From there, the doctor will guide the catheter into one of the arteries that feed blood to the fibroids. Then they will inject tiny particles called embolics into the uterine artery, blocking the flow of blood to the fibroids. Without a blood supply, the fibroids start to shrink and, eventually, die.

Moving the catheter to the other side of your uterus, the doctor will repeat the process in the other artery and after that the catheter is removed. The patient doesn’t need stitches and is usually ready to go home after a few hours of recovery.

3. How often is this procedure successful?

The particles used in UFE are inserted into the uterine artery, which supplies 99% of blood flow to the fibroids. When this blood supply is blocked, all of the fibroids are treated, meaning that the procedure will be successful.

Occasionally, the fibroid is getting enough blood from another source (for example an ovarian artery). In a vast majority of cases, this will be identified and treated at the same time as the uterine artery. The usual success rate for UFE is about 95-98% for good candidates for the procedure.

4. Are your patients happy with UFE?

Typically patients are very happy with the procedure because of the short time it takes for the procedure itself, the fast recovery time, and how quickly they see results from the procedure.

5. How safe is the UFE Procedure?

With UFE, complications are extremely rare. As with any surgical procedure, infection is possible, but is minimized with antibiotics that are prescribed to patients after the procedure.

Other than infection, there is the risk of ovarian failure or premature menopause, which affect less than 2% of patients. This potentially can happen with the patients that were approaching menopause. 

6. How long does the UFE procedure and recovery take?

The entire UFE treatment procedure typically lasts less than an hour. The post-procedure care that you receive will be administered by skilled nurses and your Interventional Radiologist. You will need to rest in bed for 2-3 hours after the procedure, but you will be able to go home the same day. 

After the procedure, you may experience some discomfort, which is very similar to menstrual cramps. You and your doctor will determine what medications may be needed to keep you comfortable (in most cases over-the-counter pain medication is enough). Most women are able to return to light activity within a few days of the uterine fibroid embolization treatment and are usually back to work and normal activity on average, within a week.

7. Will my fibroids or symptoms come back?

Uterine fibroid embolization is a procedure used to block the blood flow to the fibroids, causing them to shrink. Therefore, it is unlikely that the fibroids will come back. There are years of data available on patients who were followed up after UFE. It is rare for completely treated fibroids to re-grow. However, since UFE preserves the uterus, and depending on your age, your body may develop new fibroids

8. What happens with particles used during UFE?

The particles used to perform the embolization are microscopic and they do not move once injected into the artery. The body does not absorb them, nor do they migrate to other parts of the body or cause any harm.

9. How can the doctor be sure that the particles used during UFE go where they are supposed to go?

The entire procedure is x-ray guided, so the interventional radiologist knows precisely where the particles are going every step of the way.

10. Can UFE be used in combination with other treatments?

UFE can sometimes be used in combination with a myomectomy because it makes the subsequent more invasive procedure easier to perform and minimizes complications and blood loss.