Uterine Fibroid Embolization (UFE)

Overview

Uterine fibroid embolization (also known as UFE or Uterine Artery Embolization) reduces uterine fibroids by cutting off their blood supply with the help of small particles known as embolic agents. The procedure consists of inserting a catheter through the groin, guiding it through the uterine artery, and injecting the embolic agent into the arteries that supply blood to the uterus and fibroids. As the fibroids diminish and die, the uterus recovers completely.

Diseases treated with Uterine fibroid embolization

Uterine fibroids

Preparation for Uterine fibroid embolization

If you are a candidate for treatment, magnetic resonance imaging (MRI) or ultrasound of the uterus will be performed. In addition to assessing the size, number, and location of your fibroids, these examinations will aid in treatment planning. Your physician may suggest a pregnancy test. Patients who are pregnant should not undergo the UFE. Your doctor may want to perform a laparoscopy to examine your uterus directly. If you experience heavy menstrual bleeding, an endometrial biopsy may be performed. Before your procedure, you may be asked to stop taking aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), or blood thinners. You must inform your physician of any recent illnesses or other medical conditions. The hospital will inform you of the medications you may take the morning of the scheduled procedure, as well as the potential length of your hospital stay.

Procedure

Uterine Fibroid Embolization is an image-guided, minimally invasive procedure that employs a high-definition x-ray camera to guide a trained specialist, most often an interventional radiologist, to insert a catheter into the uterine arteries and deliver the particles. Typically, the procedure is performed in a catheterization laboratory or occasionally in an operating room.

During the procedure, you will be positioned on an exam table and connected to monitors that track your heart rate, blood pressure, and pulse. In order to administer sedative medication intravenously, a nurse or technician will insert an intravenous (IV) line into a vein in your hand or arm. Additionally, you may receive general anesthesia. The area of your body that will receive the catheter will be shaved, sterilized, and draped with a surgical drape.

The doctor will administer a local anesthetic to numb the area. At the site, a very small nick will be made in the skin. A catheter is inserted into your femoral artery, which is located in the groin, using x-ray guidance. The doctor will insert and guide the catheter to the uterine arteries using fluoroscopy. The embolic agent will be injected through the catheter and into the artery in order to cut off the fibroid’s blood supply. By repositioning the catheter that was initially inserted, the embolic agent is released into both the right and left uterine arteries. One small puncture of the skin is required for the entire procedure.

There are four different types of embolic agents: polyvinyl alcohol, GelfoamTM, microspheres, and polyacrylamide-coated spheres. The catheter will be removed and pressure will be applied to stop any bleeding at the conclusion of the procedure. A dressing is then applied to the wound in the skin. No stitches are required. Typically, one night is required for observation of the patient. The length of the procedure is approximately 90 minutes.

Benefits of Uterine fibroid embolization

Under local anesthesia, uterine fibroid embolization is significantly less invasive than open surgery to remove uterine fibroids or the entire uterus (hysterectomy).
No surgical cut is required
In most cases, patients are able to resume their normal activities many days sooner than if they had a hysterectomy.
Blood loss is minimal during uterine fibroid embolization, recovery time is significantly shorter than after hysterectomy, and general anesthesia is not necessary.
After uterine fibroid embolization, pregnancy is possible, even if there are risks involved
Nearly 90 percent of women whose fibroids are treated with uterine fibroid embolization experience either significant or complete resolution of their fibroid-related symptoms, according to follow-up studies. This is true for women experiencing heavy menstrual bleeding as well as those experiencing bulk-related symptoms such as pelvic pain or pressure
After uterine fibroid embolization, it is uncommon for treated fibroids to regrow or for new fibroids to develop, according to long-term studies. This is because the procedure treats all fibroids present in the uterus, including early-stage masses that may not be visible on imaging studies