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Uterine Fibroid Embolization (UFE)

Treatment Overview

Uterine fibroid embolization is a treatment to destroy or shrink uterine fibroids, which are benign (non-cancerous) tumours of the uterine wall or muscle.

During the procedure, the doctor inserts a thin, flexible tube called a catheter into blood vessels in both of your upper thighs. The doctor sends tiny particles through the catheter. These particles prevent your fibroids from getting blood. Without blood, the fibroids shrink or die.

You will be awake during the procedure. You will be given medicine to help you relax and to help with pain. The treatment usually takes 1 to 3 hours.

Most women go home 6 to 24 hours after the treatment. You will probably need about 7 to 10 days to fully recover. You may have some pain for a few hours to a few days after the treatment as the fibroids shrink.

This treatment should decrease pain and heavy bleeding caused by fibroids. It may also prevent your fibroids from growing back. After the procedure, you will have less blood flow to your uterus. Because of this, pregnancy is not recommended after uterine fibroid embolization. Talk with your doctor about birth control options.

What To Expect

When the procedure is over, the catheter is removed and pressure is applied to the puncture site for 10 to 15 minutes, unless there are problems with bleeding. A bandage is then applied. You can expect to have at least 6 hours of bedrest after the procedure.

You may be sent home after the bedrest period if your pain is under control. Or you might spend the night in the hospital for more observation or pain control. This will depend on your radiologist's normal practice. And it will depend on how well you do after the procedure.

Moderate to severe pelvic pain is common for 6 to 12 hours after this procedure. A stay in the hospital and opioid pain medicine are used to control this pain, if needed. You can also ask for antinausea medicine if you have nausea or vomiting. Some people can control their pain with non-steroidal anti-inflammatory drugs, such as ibuprofen or aspirin. Be safe with medicines. Read and follow all instructions on the label.

You may have some vaginal bleeding for a couple of weeks. This is from a fibroid that is breaking down and bleeding.

In some cases, bleeding or pain can last for several months. Some women also pass a fibroid from the vagina, usually 6 weeks to 3 months after having UFE. This can happen even a year later. If you do pass fibroid tissue, see your doctor right away to be sure that you don't get an infection or have problem bleeding.

You should be able to return to your usual activities in 7 to 10 days.

Recommended follow-up care after UFE includes a checkup 1 to 3 weeks afterward and an ultrasound or MRI 3 to 6 months later.

Why It Is Done

Uterine fibroid embolization (UFE) is used to shrink or destroy uterine fibroids. It is one type of treatment used in people who don't want to treat fibroids with a hysterectomy, don't plan to be pregnant in the future, and haven't reached menopause. Although there are no size limits, UFE is not recommended for all types of fibroids.

If you are strongly against ever having a hysterectomy, UFE may not be a reasonable option for you. In some cases of infection or uterine damage, UFE has led to a need for a hysterectomy.

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How Well It Works

UFE is an effective treatment, but fibroids may return.

  • Uterine fibroid embolization reduces the size of fibroids an average of about 50%.footnote 1
  • Approximately 80 out of 100 women treated with UFE for uterine fibroids report that their symptoms improved.footnote 1
  • UFE does not always cure fibroids. In one study, nearly 1 out of 5 women who had UFE had a repeat UFE or a hysterectomy within the next couple of years.footnote 2

Risks

The rate of complications after uterine fibroid embolization (UFE) is low but includes:

  • Infection. This is the most serious, potentially life-threatening complication of UFE. In rare cases, a hysterectomy is needed to treat an infected uterus.
  • Premature menopause. This seems more likely to happen to women over 40 years of age than in younger women.
  • Loss of menstrual periods (amenorrhea).
  • Scar tissue formation (adhesions).
  • Pain that lasts for months.

References

Citations

  1. Practice Committee of the American Society for Reproductive Medicine, Society of Reproductive Surgeons (2008). Myomas and reproductive function. Fertility and Sterility, 90(3): S125–S130.
  2. Lethaby A, Vollenhoven B (2011). Fibroids (uterine myomatosis, leiomyomas), search date June 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.

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