Symptoms:

• Uterine pressure or pain
• Heavy menstrual bleeding
• Pain with intercourse
• Constipation
• Low back pain
• Frequent urination and increased urinary urgency

Women are at increased risk for developing fibroids if they are African-American, over the age of 40, have not had children, are overweight, or have a first-degree relative with fibroids.  Diagnosis is usually confirmed by ultrasound or MRI.

Uterine Fibroid Embolization (UFE):

Uterine fibroid embolization is a minimally invasive treatment option for patients with symptomatic uterine fibroids with less risk, less pain, and less recovery time than traditional surgical options.

Fibroids require a blood supply to grow.  To treat uterine fibroids, interventional radiologists access the blood vessels supplying the uterine fibroid by a needle stick and without incisions or stitches.  Once a catheter is in the proper position, the supplying blood vessels are embolized or blocked by releasing small particles into the uterine blood vessels.  Embolizing the blood vessels starve the fibroids of nutrients causing the fibroids to soften and shrink in size.  By doing this procedures, over 90% of patient with fibroids will have symptom relief.

The risks of the procedure are minimal but include infection, bleeding, or adverse reactions to the imaging agents used during the treatment.  There is a small risk of inducing menopause, especially in women over 45 years of age.  Within the first week following the procedure, some women may experience symptoms of post-embolization syndrome, including pelvic pain and cramping, nausea and low-grade fever.  These symptoms may resolve themselves and disappear within 2-7 days.

Uterine Fibroid Embolization Treatment Video

Advantages of UFE:

• Preserves the uterus
• Minimally invasive
• Low complication rate
• Quicker recovery compared to surgery
• Treats all fibroids with one procedure
• Recurrence is rare
• General anesthesia is not necessary
• Patients discharged either same or next day

What to expect after UFE:

• You will be prescribed medicines for pain control
• You may not drive while taking prescription pain medicines
• Symptoms will markedly improve in over 90% of patients
• You will need to take 1-2 weeks off work (compared to 4-6 weeks following surgical treatments)

UAE is considered to be an alternative to hysterectomy, the surgical removal of the uterus, because it has been shown to be similarly effective in treating these conditions while having fewer complications and a faster recovery time.

Several studies have shown that UAE is a safe and effective alternative to hysterectomy for the treatment of fibroids. A systematic review and meta-analysis published in 2016 in the Journal of Vascular and Interventional Radiology found that UAE was non-inferior to hysterectomy in terms of symptom relief and quality of life, and that it had a significantly lower complication rate.

Another study published in the same year in the Journal of Minimally Invasive Gynecology found that UAE was associated with fewer complications, shorter hospital stays, and faster recovery time compared to hysterectomy.

References:

• Spies, J. B., Ascher, S. A., Roth, A. R., & Soslow, R. A. (2016). Uterine artery embolization versus hysterectomy in the management of leiomyomas: a systematic review and meta-analysis. Journal of vascular and interventional radiology : JVIR, 27(9), 1389-1398.
• Spies, J. B., & Ascher, S. A. (2016). Uterine artery embolization for abnormal uterine bleeding: a review. Journal of minimally invasive gynecology, 23(3), 295-305.