A Minimally Invasive Solution for Symptomatic Fibroids

Uterine Fibroid Embolization (UFE) is a minimally invasive, image-guided procedure performed by an interventional radiologist to treat symptomatic uterine fibroids — non-cancerous growths in the uterus. UFE offers an alternative to surgical procedures like hysterectomy or myomectomy while preserving the uterus.

Diagnostics and Treatment of Uterine Fibroids:
Diagnosing uterine fibroids begins with a thorough clinical evaluation. The initial assessment includes a review of the patient’s medical history, with a focus on menstrual patterns, pelvic pain, fertility concerns, and any previous treatments. A pelvic exam is then performed to evaluate uterine size and detect any tenderness or irregularities. Imaging studies play a critical role in confirming the diagnosis. Pelvic ultrasound—both transvaginal and transabdominal—is the first-line imaging modality used to assess the size, number, and location of fibroids. For more detailed mapping, especially when considering Uterine Fibroid Embolization (UFE), an MRI of the pelvis is considered the gold standard. It helps determine the exact fibroid characteristics and uterine anatomy. Additional tests, such as hysterosonography or hysteroscopy, may be used in select cases where the fibroids distort the uterine cavity.

Common symptoms of uterine fibroids include heavy menstrual bleeding (menorrhagia), pelvic pain or pressure, abdominal bloating or fullness, frequent urination, constipation, and pain during intercourse. In some cases, fibroids can cause lower back pain, anemia due to chronic blood loss, and fertility issues or recurrent pregnancy loss.

Treatment options for fibroids range from non-surgical to surgical interventions, depending on symptom severity, fibroid size and location, and the patient’s reproductive goals. Non-surgical options include medications such as hormonal therapies (e.g., GnRH agonists), birth control pills, tranexamic acid, and NSAIDs to manage symptoms. MRI-guided focused ultrasound is a non-invasive treatment that uses high-intensity sound waves to destroy fibroid tissue, though its availability may be limited. Surgical options include myomectomy, which removes fibroids while preserving the uterus, and hysterectomy, the complete removal of the uterus, which provides a definitive cure. A minimally invasive and highly effective alternative is Uterine Fibroid Embolization (UFE), which preserves the uterus, avoids major surgery, offers a faster recovery, and provides symptom relief in approximately 85–95% of patients.

Uterine Fibroid Embolization is a safe, effective, and minimally invasive procedure for treating symptomatic fibroids. It offers excellent symptom relief with a fast recovery and no surgical incisions.

Pre-Operative Process:

Before undergoing UFE, patients will first have a consultation that includes a detailed review of symptoms and confirmation of fibroids through MRI imaging. This step ensures the patient is an appropriate candidate, excluding individuals who are pregnant, have an active pelvic infection, or have an excessively large uterus. Pre-procedure labs, including a complete blood count to check for anemia and kidney function tests, are typically ordered. Patients may also be prescribed antibiotics prophylactically and receive a pain management plan in advance. Instructions include refraining from eating or drinking (NPO) after midnight prior to the procedure and arranging transportation home afterward.

During the Procedure:

UFE is usually performed as an outpatient procedure in an interventional radiology suite. The patient receives conscious or moderate IV sedation, allowing them to remain relaxed and awake without the need for general anesthesia. The procedure begins with a small puncture in either the groin (femoral artery) or wrist (radial artery), through which a thin catheter is inserted. Guided by real-time X-ray (fluoroscopy), the catheter is navigated into both uterine arteries. Tiny embolic particles, made from biocompatible plastic or gelatin, are then injected to block blood flow to the fibroids, causing them to shrink and die while preserving the surrounding uterine tissue. After embolization, the catheter is removed, pressure is applied to prevent bleeding, and a small bandage is placed—no large incisions are required. The entire procedure typically lasts between 60 and 90 minutes..

Post-Operative Care:

Following the procedure, patients are monitored for several hours. IV pain medications are given initially, then transitioned to oral medications. Nausea, if present, is also managed. Post-embolization symptoms are common and may include moderate to severe cramping or pelvic pain within the first 24–48 hours, low-grade fever, fatigue, malaise, and occasional gastrointestinal upset. This combination of symptoms, known as Post-Embolization Syndrome, is a normal part of recovery. Discharge instructions typically include resting for 24-48 hours, gradually returning to normal activities within 2–10 days, and avoiding heavy lifting for at least a week. A follow-up appointment is scheduled within 8 weeks.

Long-Term Recovery & Outcomes:

Over the course of recovery, fibroids typically shrink by 30–50% in volume within three months, with further reduction continuing for up to 6–12 months. Most patients experience significant symptom relief: heavy menstrual bleeding improves in about 90% of cases, and pelvic pressure or pain improves in approximately 85–95%. Menstrual cycles usually return to normal, often becoming lighter and less painful. Although UFE preserves the uterus, its impact on future fertility is still being studied, so patients who wish to become pregnant should discuss options and risks with their physician.