Uterine Fibroid Embolization

Columbia Radiology's interventional radiologists are experts in minimally invasive treatment for uterine fibroids. 

Using image guidance and tiny tools, our interventional radiologists perform thousands of procedures each year to treat uterine fibroids and other conditions that would otherwise require open surgery. Most patients go home on the day of their procedure with a Band-Aid instead of an incision.

A consultation with an interventional radiologist can help determine whether uterine fibroid embolization (UFE) is the right treatment for you.

Fibroid Treatment at Columbia Interventional Radiology

Fibroids are benign (non-cancerous) tumors made up of muscular and fibrous tissue that develop from the smooth muscle cells of the uterus. Fibroids can be microscopic in size or grow as large as a cantaloupe. They very rarely become cancerous.

While some women with fibroids have no symptoms, others can develop symptoms which include excessive bleeding, pain or pressure on the bladder and bowel, an enlarged belly, and loss of fertility. Fibroids that are not causing symptoms usually do not require treatment. 

UFE is a minimally invasive, safe, and highly effective treatment for uterine fibroids—one of the alternatives to hysterectomy (complete removal of the uterus). During this procedure an interventional radiologist uses live X-ray imaging to navigate a catheter (a thin, hollow tube) to the arteries that supply the fibroid with blood. Tiny round beads—each measuring the size of a grain of sand—are injected into the catheter and into the fibroid-feeding vessels. The tiny beads block the blood flow to the fibroids, causing the fibroids to shrink. 

Am I a candidate for uterine fibroid embolization?

Studies have shown that nearly 90 percent of women who undergo UFE experience significant or complete resolution of their fibroid-related symptoms. Patients who are ideal candidates for UFE include women who:

• Have symptomatic fibroids
• Want to keep their uteruses
• Want a faster recovery time
• May not be good candidates for surgery

You should not have this procedure if you are pregnant. Scientific studies have not yet fully established whether UFE affects fertility, although healthy pregnancies have been documented in women who have had the procedure. As with any medical intervention, discuss the most current clinical data with your doctor before deciding on the fibroid treatment that is best for you.

What will happen during the procedure?

After midnight on the evening before your procedure you should not eat or drink anything. Your doctor will tell you which medications you may take in the morning.

When you arrive for your procedure, we will ask you to change into a gown and escort you to the procedure room. We will administer a local anesthetic to numb the skin over your wrist or groin. Then we will insert a needle to access your artery. This needle provides access for a catheter, which we guide to the uterine artery up to the point where it divides into multiple vessels that supply blood to the fibroids. Your doctor will use an X-ray technique called fluoroscopy to guide the catheter into position.

Once the catheter is in place, we inject contrast dye into the artery, which enables us to see the blood supply to the fibroids. Then, we slowly inject an embolic (blocking) agent (synthetic particles the size of grains of sand) into the artery through the catheter. The embolic agent flows with the blood toward the fibroids and becomes wedged in the vessels supplying the fibroids with blood. We continue the procedure for several minutes until the blood flow is completely blocked. Blood flow will continue to other parts of the uterus.

Once the embolization is complete, we gently remove the catheter. The entire procedure usually takes less than one hour. You will then recover in your own private room until you are ready to go home. Most patients return to work in one to two weeks.

Are there any risks?

The procedure is relatively safe when performed by an experienced interventional radiologist. Major complications that can occur include:

• Post-embolization syndrome consisting of pain and a low grade fever
• Premature amenorrhea: some women no longer have menstrual periods after UFE. This is unusual in women under 35 and is not associated with menopause symptoms.
• Endometritis: infection of the lining of the uterus. This rarely occurs and can be successfully treated with antibiotics in most cases.

Please discuss all risks and benefits with an interventional radiologist during your consultation.

After the procedure

Most UFE patients are scheduled as the first case of the day in our outpatient office and go home later in the day. You will likely need about four days at home to recover, and most patients feel back to normal after seven to 14 days.

Most women experience six to 12 hours of severe cramping after UFE. We usually treat your pain with an intravenous painkiller while you are in our recovery area and then switch to an oral painkiller that you can take at home. The pain usually decreases significantly over the first few days. By your fourth or fifth day, painkillers are usually required only once or twice a day.   

During the first week after UFE you might experience normal and expected side effects including fever, fatigue, nausea, cramps, and abdominal pain.

Follow-up

We will schedule a follow-up appointment about two weeks after the procedure. If needed, we may order imaging tests to check the status of the fibroids between six months and a year after the procedure.