Uterine fibroid embolization (UFE) is a minimally invasive treatment for fibroid tumors of the uterus. Fibroids are non-cancerous (benign) growths that begin on and extend from the wall of the uterus. Often, women who have fibroids do not notice any negative symptoms. For some women, however, fibroids cause heavy periods; unusual periods (sometimes with blood clots); bladder, bowel or pelvic pain; pain in the back and legs; pain that accompanies sexual intercourse; a frequent urge to urinate; constipation; and bloating or a swollen stomach.
Traditionally, fibroids that caused severe symptoms were treated with a hysterectomy (surgical removal of the uterus) or a myomectomy (surgical removal of the fibroids). Today, there are other less invasive options for treating fibroids such as the UFE procedure.
During a UFE procedure, physicians use a fluoroscope (an x-ray camera) to guide a catheter that is inserted into the groin. The catheter is moved up into the uterus, and is then used to deliver a chemical into the arteries that supply blood to the uterus and fibroids. Without sufficient blood flow, the fibroids die and shrink.
A UFE procedure is typically performed in a specialized catheter lab or in an operating room using sedation and a local anesthetic (numbing the area). After the procedure, patients remain in the hospital overnight, and typically return home the next day. Some women experience pelvic cramps, nausea and a fever directly after the treatment. The cramps typically subside over the next few days. Any remaining pain or cramps are treated with oral medication after the patient leaves the hospital. Patients typically return to normal activities within two weeks.
Fibroid shrinking occurs over the course of several months (up to 6 months) after the UFE. During this time, women may have decreased menstrual bleeding. Some patients skip a period or two, or stop having periods altogether.
For many women, UFE is considered a more attractive alternative than a hysterectomy. Besides allowing a patient to retain her uterus, the UFE treatment typically does not require general anesthesia (the patient is totally asleep) and does not involve a long surgical incision. Blood loss associated with the procedure is minimal and the recovery time is much faster than for women who have a hysterectomy.
The ideal candidate for a UFE procedure is a woman with symptomatic fibroids who is no longer interested in becoming pregnant, is premenopausal, and is interested in preserving her uterus.
What patients should ask their doctor about a hysterectomy for fibroids
Women should be educated about the different alternatives for treating symptomatic fibroids. Patients who have been advised to have a hysterectomy for fibroids should ask the following questions:
What are the surgical and non-surgical options for treating fibroids?
What are the advantages, risks, and benefits of each of these treatments?
What are the best treatment options for me?
Am I a good candidate for UFE?