70-80% of women have benign uterine fibroid tumors by the time they reach age 50. Most often, they cause no symptoms, and many women are unaware that they have them at all. However, fibroids also cause many women a great deal of discomfort. Depending on their size and location, uterine fibroids can cause
- Heavier periods
- Longer periods
- Increased menstrual pain
- Pelvic pain
- Frequent urination or difficulty emptying bladder
- Back aches
- Leg pains
Depending on your symptoms and other factors, your doctor may recommend treatment options ranging from watchful waiting or drugs to hysterectomy. Uterine fibroid embolization (UFE) is a minimally invasive surgical procedure used to treat fibroids and their symptoms. Approximately 80-90% of women who undergo UFE experience relief of their symptoms following the procedure.
What is uterine fibroid embolization?
During a UFE procedure, an interventional radiologist delivers embolic (blood vessel-blocking) agents to the arteries providing blood supply to the tumors, causing the fibroids to shrink. UFE has been found to be very safe and has a much faster recovery time than hysterectomy.
How should I prepare for the procedure?
Before your procedure is scheduled, the size and location of the fibroid tumors must be determined. Your doctor will schedule a contrast-enhanced MRI or other uterine imaging exam for this purpose. After this is performed, and you and your doctor determine that UFE is the best course of action, you can do the following things to prepare:
- Tell your doctor about any recent illnesses and all medications you are taking, including supplements. You will likely be instructed to discontinue medications such as anticoagulants, aspirin, and NSAIDs prior to the procedure.
- Tell your doctor (and the imaging clinic) if there is any chance you may be pregnant. UFE is not an option for pregnant patients.
- Ask any and all questions and raise any concerns that you have about the procedure, and make sure you get answers that satisfy you.
- Plan to stay at the hospital overnight.
- Plan to take at least one week off work and to rest for at least a few days.
- Wear a loose-fitting 2-piece outfit to the hospital. (You’ll be glad when it’s time to change back into it to go home.)
What should I expect during the procedure?
To begin the procedure, you will be positioned on the exam table, and a nurse will insert an IV and begin monitoring your vital signs. You will receive moderate sedation so that you will remain conscious but feel relaxed and sleepy. The incision area will be shaved, sterilized, draped, and locally anesthetized. A very small (less than 1/4”) incision is made, and a thin (about 1/8”) plastic catheter is inserted into the femoral artery in the groin. Guided by contrast-enhanced fluoroscopy, the catheter is moved into the uterine arteries, where the embolic agents are released. The catheter is removed, and the incision is dressed. No suturing is necessary. The entire procedure takes about two hours.
What should I expect after the procedure?
You will likely spend 24 hours under hospital supervision. During this time, your pain can be controlled with medications delivered through your IV. When you’re discharged from the hospital, you may be given prescriptions for oral medications to control pain and inflammation.
It is normal to experience abdominal cramping, mild nausea, low energy, and low-grade fever (101° or below) for the first several days following UFE. Vaginal discharge, which may be discolored, is not uncommon and may last several weeks. However, contact your doctor if you experience any of the following symptoms:
- Fever above 101°
- Foul-smelling discharge
- Increasing pain
- Skin hot to touch around incision site
- Bleeding from incision
- Sudden increase in drainage
You will likely experience relief from your symptoms over the course of several months. It is common for the first menstrual period following UFE to be much lighter and for periods to gradually increase to a new level that is much lower in flow and intensity than they were prior to treatment. Fibroids will shrink and soften over time, and symptom improvement should be complete after about six months.
What risks are involved with UFE?
Any surgical procedure involves a chance of infection, but this risk is very small. The estimated chance of contracting an infection requiring antibiotics from UFE is less than 1 in 1,000. There is also a small risk of damage to blood vessels (less than 1%) and the need for a follow up dilatation and curettage (D & C) procedure in the event that fibroids detach following treatment (2-3%). Some women (1-5%, mostly those over 45 years old) experience menopause immediately following UFE. Be sure to ask your doctor about any additional risks you should be aware of. You can see a more complete discussion of the risks and benefits of UFE at Radiologyinfo.org.
Iowa Radiology's Interventional Radiologists provide consultations for uterine fibroid embolization at our downtown Des Moines clinic and perform the procedure at Unity Point Iowa Methodist Medical Center. If uterine fibroids are interfering with your quality of life, discuss treatment options with your doctor, who can provide you with a referral to our clinic if appropriate.
Iowa Radiology provides a wide range of imaging services in the Des Moines area. We are dedicated to providing the highest level of patient care and customer service and are always happy to discuss any questions or concerns you have about your procedure with us.
Feel free to download either of our free eBooks, which contain lots of helpful information about common imaging procedures.
"Uterine Fibroid Embolization (UFE)." Radiologyinfo.org. Radiological Society of North America, n.d. Web. 7 April 2016.
"Uterine Fibroid Embolization (UFE)." WebMD. WebMD LLC, n.d. Web. 7 April 2016.
"Uterine Fibroids." MayoClinic.org. Mayo Foundation for Medical Education and Research, n.d. Web. 7 April 2016.
"Uterine Fibroids (Benign Tumors Of The Uterus)." MedicineNet.com. MedicineNet Inc., n.d. Web. 7 April 2016.
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