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Uterine Fibroid Embolization

Uterine Fibroid Embolization

WomanCare Clinic

Meriter WomanCare Clinic
20 S. Park Street, Suite 450
Madison, WI 53715
Telephone: (608) 417-5433 or 1-888-409-3852

UW Health - OB/GYN
20 S. Park Street, Suite 307
Madison, WI 53715
Telephone: (608) 287-2830

Definition

        
Uterine fibroid embolization is a minimally invasive procedure performed to treat symptoms caused by uterine fibroids.

Alternative Names

      
Uterine Artery Embolization

Benefits of the Procedure

  • No incision or stitches
  • Short recovery time, compared to alternative treatments
  • Blood loss is minimal
  • No general anesthetics
  • Much less invasive than having a hysterectomy

Symptoms

  • Abnormal menstrual bleeding
  • Pelvic pain
  • Urinary Frequency
  • Constipation

What is Uterine Fibroid Embolization?

         
Uterine fibroid embolization is usually performed in a hospital by a skilled interventional radiologist. Prior to the procedure, imaging of the uterus by magnetic resonance imaging (MRI) or ultrasound will be performed to ensure that fibroid tumors are the cause of the patient’s symptoms. The imaging is also used for the doctor to know the size, number and location of the fibroids. In some cases, the prior imaging may result in cancellation of the procedure.


As part of the uterine artery embolization procedure, the patient has an arteriogram. An arteriogram is an injection of contrast material that shows up with x-ray imaging. It is performed to see how the patient’s blood supply reaches the uterus and fibroids.


A small hole is made at the very top of the patient’s leg to insert a catheter, a thin flexible tube, into the femoral artery (usually on the right). The catheter allows the doctor to inject contrast materials to visualize the arteries and an embolic agent, usually a gelatin material, into one or more of the blood vessels that supply the fibroid tumors with blood. Because fibroids are very vascular, the embolic agent particles flow to the fibroids first. This cuts off the blood flow to the fibroids and causes them to shrink or die.


The embolization process is continued until there is near complete blockage of both uterine arteries to ensure the entire blood supply to the fibroids is blocked. After the left and right uterine arteries are blocked, another arteriogram may be performed. The entire procedure may take between one and two hours.


At the end of the procedure, the catheter will be removed and pressure will be applied to stop any bleeding. The very small opening in the skin is then covered with a dressing.

Risks

  • Bleeding at the puncture site
  • Infection
  • Having menopause occur shortly after the procedure (occurs in approximately 5% of cases).
  • Very rare serious side effects including the development of blood clots that travel to the lungs or life-threatening infection.

Rehabilitation

          
Patients usually stay overnight in the hospital to have their pain monitored and treated as needed. Most patients have significant cramping for a few hours after the procedure. Some patients may experience nausea after the procedure, and a low-grade fever could occur after one or two days. A bruise may develop at the catheter entry site. The post-procedure symptoms usually resolve within a week, and patients typically can return to work at that time. In approximately 85% of case, the symptoms caused by the fibroids will be eliminated or significantly reduced, but this relief of symptoms may take several months. It is common for heavy bleeding to improve during the first menstrual cycle following the procedure. In most premenopausal women, regular menstrual periods return after one or two months.


Uterine artery embolization is usually performed on women who are near the end of their child-bearing years, and who are not concerned with maintaining their fertility. Normal pregnancies have been reported after the uterine artery embolization procedure, but its effect on conception and the ability to carry a pregnancy to term is not well known.