Uterine artery embolization (often referred to as “uterine fibroid embolization” or “UFE”) is an innovative outpatient procedure most commonly used to treat symptomatic fibroids. It can also be performed to improve adenomyosis symptoms.
This minimally invasive treatment option preserves the uterus and avoids surgery. During this procedure, a board-certified interventional radiologist uses pre-procedure MRI imaging, real-time fluoroscopy, and minimally invasive techniques to block the blood supply to the fibroids, causing them to shrink over time. In the case of adenomyosis, the blocked blood vessels displace tissue causing adenomyosis.
Who is an Ideal Candidate for Uterine Artery Embolization?
Uterine artery embolization is an effective procedure for improving painful symptoms caused by fibroids and adenomyosis. The benefits of uterine artery embolization include:
- Relief from fibroid or adenomyosis symptoms within three to six months
- Effective relief of anemia, which eliminates the need for iron supplements or blood transfusions
- Protection of healthy tissue, including the uterus and ovaries
- Short recovery because it is a minimally invasive procedure
Most fibroid sizes and locations can be treated with this procedure. For some patients, however, their fibroids are too large or located in too challenging a location within the uterus for the treatment to be successful.
At the Weill Cornell Medicine Fibroid and Adenomyosis Program, all patients receive an extensive evaluation, including mapping of all fibroids. They are then evaluated by a team of specialists to determine if they are suitable candidates for uterine artery embolization.
Considerations
As a minimally invasive surgery, the complications and recovery time after the procedure are minimal. Uterine artery embolization can cause bleeding and injury to internal organs, but this is rare.
If you are nearing menopause (perimenopausal), the procedure may cause menopause, but this is very rare (less than two percent).
Patients have had healthy pregnancies after uterine artery embolization. However, there is limited data about the procedure and pregnancy. Some evidence suggests that the placenta is more likely to attach to the uterus abnormally after this procedure, causing a miscarriage.
Uterine artery embolization is not appropriate for those with any condition affecting blood vessels (vascular disease), past pelvic infections, or pelvic cancer.
What to Expect During Uterine Artery Embolization
You will be given sedation medication to help you relax, but you will be awake and able to communicate during the procedure (this is often called conscious sedation). You will also receive a catheter to drain your bladder during the procedure.
During uterine artery embolization, a board-certified interventional radiologist uses ultrasound to guide a needle and catheter into the larger artery in the leg (femoral artery), or a small artery in your left wrist (radial artery). Using real-time fluoroscopic guidance, the catheter is then guided into specific arteries in the uterus.
Embolic beads are injected into the uterine arteries to block the blood vessels from supplying oxygen and nutrients to the fibroids. By blocking the blood supply, the unwanted tissue breaks down, dies, and shrinks. Embolic beads may also be injected to displace the tissue causing adenomyosis.
What to Expect During Recovery
Uterine artery embolization is an outpatient procedure; no hospital stay is required. Typically, you can leave the hospital a few hours after the procedure, begin work and mild activity in a few days, and recover fully within two weeks. You are prescribed medications to lessen pain and swelling.
For several weeks after the procedure, it is common to experience watery or mucus-like vaginal discharge. A small number of patients may experience post-embolization syndrome a few days after the procedure, which includes a low- grade fever, nausea, pain, fatigue, or vomiting.
By three months after the procedure, most patients experience relief from fibroid or adenomyosis symptoms, and menstruation typically returns to normal.
Recovery complications to monitor: Be sure to call your physician if you continue to experience post-embolization syndrome for several days after the procedure.
Follow-up care: Patients at the Weill Cornell Medicine Fibroid and Adenomyosis Program have a follow-up visit, either in person or via telehealth, one week after the procedure.
Why Choose Weill Cornell Medicine for Uterine Artery Embolization?
There are many treatment options available to women who suffer from fibroids or adenomyosis. Treatment options range from medical therapy to surgery, with many other options in between.
The team at the Weill Cornell Medicine Fibroid and Adenomyosis Program is proud to offer the latest treatment options and provide personalized care for our patients. By getting to know and listening to our patients, we understand their needs, as well as their most difficult symptoms.
Our team has achieved remarkable success in treating patients with the uterine artery embolization procedure. Our specialists carefully evaluate each patient to determine if they are suitable candidates for this innovative treatment option.
Our team of minimally invasive gynecologic surgeons and interventional radiologists collaborates with other specialists in reproductive health, integrative medicine, and nutrition to help patients receive high-quality, personalized care.