A uterine fibroid is a specific type of tumor of the muscle cells of the uterus. They are benign growths but can alter a woman’s period in several different ways. Uterine fibroids do not spread to other parts of the body like some tumors can and are not typically dangerous. They are usually diagnosed by ultrasound or MRI. Research has shown that uterine fibroids will affect over 70% of White women and over 80% of Black women in the United States by the time they are 50 years old. You are at an increased risk of developing fibroids if you are overweight, African-American, over the age of 40, have had no children, or have a family history of uterine fibroids.

Symptoms of uterine fibroids can be divided into two different categories: bulk symptoms or bleeding symptoms. Bulk symptoms are the result of the fibroids pushing on other structures in the pelvis. They can range from a bloated feeling to an urge to urinate frequently to constipation or even to abdominal enlargement. Bleeding symptoms can range from heavy bleeding during menses to bleeding between periods. These symptoms can be so severe that some patients might require iron supplementation, or even blood transfusions.

Conventionally severe cases of uterine fibroids are treated with hysterectomy, which is the complete removal of the entire uterus. In selected cases myomectomy, which is the targeted removal of individual fibroids from the uterus.

Hysterectomy is an invasive surgical procedure that removes the entire uterus. It requires general anesthesia and a breathing tube during the procedure. The recovery can be long, taking up to several weeks, and it carries the risk of major bleeding, possibly requiring a blood transfusion or other procedures to stop the bleeding. Additional risks include infection possibly requiring antibiotics or a drainage catheter, damage to the bladder, urinary tract, rectum, or other pelvic structures requiring additional surgical procedures. There’s always the risk of adverse reaction to the anesthetic. Myomectomy is an invasive surgical procedure that removes the fibroids but leaves the uterus in place. It often requires general anesthesia and a breathing tube during the procedure. In most cases, the patient will need to spend at least one night in the hospital afterward. The risks of myomectomy include major bleeding requiring a blood transfusion or additional procedures to stop the bleeding, the development of scar tissue around the uterus, and in some cases, the surgeon may need to remove the uterus during the procedure.

Uterine fibroid embolization, or UFE, is a minimally invasive procedure that deprives the fibroids of oxygen and nutrients they need to grow by blocking the blood supply to the uterus. UFE avoids invasive surgery, preserves the uterus, controls both bulk and bleeding symptoms, and improves quality of life. Approximately 9 out of 10 women who undergo uterine fibroid embolization will see significant improvement or complete resolution of their symptoms.

Uterine fibroid embolization is an outpatient procedure performed by a specially trained doctor called an interventional radiologist. The interventional radiologist uses x-rays to guide a very thin catheter into the arteries that supply the fibroids and uterus. Once in position, we release particles to block the small blood vessels and deprive the fibroids of their nutrients causing them to shrink.

During the UFE procedure, the patient will receive sedation through an IV so that they are calm and comfortable but still breathing on their own. The procedure usually takes between one and two hours. Once the embolization is complete, the catheter is removed and pressure is applied to a small incision to allow it to heal. Afterward, the patient is observed for a short period of time before going home the very same day.

The recovery from uterine fibroid embolization is relatively quick. We do recommend that patients take it easy for the first three days after the procedure and avoid lifting anything heavy. Most patients will want to take those days off of work. Strenuous activity such as exercise should be avoided for the first week. After the first week, most patients feel well enough to resume their normal daily activities.

The risks of uterine fibroid embolization are less than the more invasive alternatives of hysterectomy or myomectomy. The risks of UFE include bleeding or infection at the incision site or adverse reaction to the imaging agents used during the procedure.

Our experience regarding the success of the uterine fibroid embolization procedure has been very positive. It typically takes about three months for the full benefit of the procedure to be appreciated and the fibroids do continue to shrink for about six to nine months after the procedure. According to large studies, approximately 85% of women who undergo the uterine fibroid embolization procedure do see a significant improvement in their symptoms. If a patient does not see the desired effects, the procedure can be repeated, and the overall successful outcomes increase to over 95%.