Uterine Fibroid Embolization (UFE)

Treatment Overview

Uterine fibroid embolization is a treatment to destroy or shrink fibroids. Fibroids are growths on or in your uterus. Sometimes they're called fibroid tumors, but they aren't cancer.

You will be awake during the procedure. You will get medicine to help you relax and to help with pain. First the doctor will put a thin, flexible tube into blood vessels in both of your upper thighs. The tube is called a catheter. Then the doctor sends small particles through the catheter. These particles prevent your fibroids from getting blood. Without blood, the fibroids shrink or die.

The treatment usually takes 1 to 3 hours. Most women go home 6 to 24 hours later.

You may have some pain for a few hours to a few days. It will probably take about 7 to 10 days to fully recover.

This treatment should reduce pain and bleeding. It may also prevent fibroids from growing back. After the treatment, less blood will go to your uterus. Because of this, pregnancy is not recommended. So it's important to talk with your doctor about birth control options.

What To Expect

When the procedure is over, the catheter is removed and pressure is applied to the puncture site for 10 to 15 minutes, unless there are problems with bleeding. A bandage is then applied. You can expect to have at least 6 hours of bed rest after the procedure.

You may be sent home after the bed rest period if your pain is under control. Or you might spend the night in the hospital for more observation or pain control. This will depend on your radiologist's normal practice. And it will depend on how well you do after the procedure.

Moderate to severe pelvic pain is common for 6 to 12 hours after this procedure. A stay in the hospital and opioid pain medicine are used to control this pain, if needed. You can also ask for antinausea medicine if you have nausea or vomiting. Some people can control their pain with nonsteroidal anti-inflammatory drugs, such as ibuprofen or aspirin. Be safe with medicines. Read and follow all instructions on the label.

You may have some vaginal bleeding for a couple of weeks. This is from a fibroid that is breaking down and bleeding.

In some cases, bleeding or pain can last for several months. Some women also pass a fibroid from the vagina, usually 6 weeks to 3 months after having UFE. This can happen even a year later. If you do pass fibroid tissue, see your doctor right away to be sure that you don't get an infection or have problem bleeding.

You should be able to return to your usual activities in 7 to 10 days.

Recommended follow-up care after UFE includes a checkup 1 to 3 weeks afterward and an ultrasound or MRI 3 to 6 months later.

Why It Is Done

Uterine fibroid embolization (UFE) is used to shrink or destroy uterine fibroids. It is one type of treatment used in people who don't want to treat fibroids with a hysterectomy, don't plan to be pregnant in the future, and haven't reached menopause. Although there are no size limits, UFE is not recommended for all types of fibroids.

If you are strongly against ever having a hysterectomy, UFE may not be a reasonable option for you. In some cases of infection or uterine damage, UFE has led to a need for a hysterectomy.

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How Well It Works

UFE is an effective treatment, but fibroids may return.

  • Uterine fibroid embolization reduces the size of fibroids an average of about 50%.footnote 1
  • Approximately 80 out of 100 women treated with UFE for uterine fibroids report that their symptoms improved.footnote 1
  • UFE does not always cure fibroids. In one study, nearly 1 out of 5 women who had UFE had a repeat UFE or a hysterectomy within the next couple of years.footnote 2

Risks

The rate of complications after uterine fibroid embolization (UFE) is low but includes:

  • Infection. This is the most serious, potentially life-threatening complication of UFE. In rare cases, a hysterectomy is needed to treat an infected uterus.
  • Premature menopause. This seems more likely to happen to women over 40 years of age than in younger women.
  • Loss of menstrual periods (amenorrhea).
  • Scar tissue formation (adhesions).
  • Pain that lasts for months.

References

Citations

  1. Practice Committee of the American Society for Reproductive Medicine, Society of Reproductive Surgeons (2008). Myomas and reproductive function. Fertility and Sterility, 90(3): S125–S130.
  2. Lethaby A, Vollenhoven B (2011). Fibroids (uterine myomatosis, leiomyomas), search date June 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.

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