Uterine artery embolisation for fibroids

It has been reported that about one-third of women between ages 25 and 44 reported having symptoms related to uterine fibroids. It is likely that millions of women worldwide have fibroids at any one time, but have not reported any symptoms or sought medical advice – despite the fact that it is a very treatable condition.

Uterine fibroids are benign tumours of muscle tissue that arise from the wall of the uterus. They are usually asymptomatic, but can cause pain, abnormal menstrual bleeding, urinary frequency, constipation, a feeling of abdominal bloating and pain during intercourse. Fibroids may also result in infertility.       

Women who have uterine fibroids, that are negatively impacting their quality of life, might consider seeking treatment.  Traditionally this has been a hysterectomy. This may be performed via an open surgical approach or via keyhole surgery. Both are surgical procedures and carry recognised surgical complications.

Uterine Fibroid Embolisation (UFE) is a relatively non-invasive alternative performed by a trained interventional radiologist, such as Dr Ebrahim Kader.

Recognised international studies of the long term effects of UFE reported that more than 80% of fibroid‐related symptoms were still resolved or improved 5-7 years after the initial UFE procedure, confirming the efficacy of the procedure and cementing UFE as a well-established, safer alternative to a surgical approach.

The goal of this article is to empower you to make an informed choice regarding the management of your uterine fibroids. It is important for patients experiencing uterine fibroids to weigh their treatment options carefully and know that surgery is not their only option.

Frequently asked questions:   

How are fibroids diagnosed?
Fibroids may be detected if a patient seeks medical consultation for any of the symptoms described above, but are often diagnosed incidentally during routine gynaecologic exam when your gynaecologist notices an enlarged uterus.

The diagnosis may be confirmed using ultrasound or MRI.

Read more about our ultrasound and MRI services here.

How does uterine fibroid embolization (UFE) work?
A small catheter is introduced through the artery in the groin and positioned into the arteries that feed the uterus. Tiny particles are injected into the arteries to stop blood flow.

The muscular wall of the uterus tolerates this well with no ill effects, but the fibroid, deprived of its blood supply, dies. Over time it will shrink as much as 70% allowing for improvement or complete resolution of symptoms.

The procedure takes about an hour to perform.

Why choose UFE, instead of a hysterectomy?
UFE is not a major surgery and the recovery time is considerably shorter than a hysterectomy, which can be as long as 3 months, while patients who opt for UFE are usually back to their normal routine within days.

You will likely be required to stay in the hospital overnight to be monitored for pain and discharged the following day. You can resume normal activity levels such as driving and exercising within a few days after the procedure.

Is general anaesthesia required?
No. UFE is performed under monitored conscious sedation.

This means you will be sedated but conscious during the procedure. A local anaesthetic is used to numb the site where the radiologist inserts the catheter. UFE is well tolerated, and many patients don’t remember anything about the procedure due to the effects of the “twilight” sedation.

What is the success rate of UFE?
According to the combined results of major studies of UFE, the average success rate is approximately 90%. After five years, approximately 80% of patients are asymptomatic. In other words, in 4 out of 5 patients, it is not necessary to have a hysterectomy or other treatment for uterine fibroid disease.

Is the procedure painful?
The procedure itself is not painful. Most women experience moderate to severe pain and cramping during the first 8-12 hours after the procedure. The use of intravenous and/or oral pain medications makes any pain tolerable.

Is there a limit to the number and size of fibroids that can be treated?
There is no limit on the number of fibroids that can be treated. One of the advantages of UFE is that it treats all fibroids at once.

Can my gynaecologist perform this procedure?
Diagnosing and identifying the treatment options for Uterine Fibroids is a collaborative effort between your gynaecologist and a specially trained interventional radiologist.

The procedure will however be performed by the interventional radiologist, who is specially trained to perform this delicate procedure with micro tools.

What are the risks of delaying or avoiding treatment?
While many women experience minimal symptoms from their fibroids, these can enlarge over time, causing symptoms to worsen. Left untreated, fibroids may also cause infertility.

Can I still become pregnant after UFE?
Yes. There are many women who have delivered healthy babies after embolization, many of whom were told that they would never be able to conceive. No problems, either during pregnancy or delivery, have been directly attributed to embolization.

Can fibroid removal cause cancer?
UFE treatment cannot cause cancer. The fibroid tumour tissue simply shrinks as its blood supply is blocked by the UFE treatment. It is the shrinkage of the fibroid tumour which results in the alleviation of symptoms.

Will I get my flat stomach back after UFE?
The fibroid(s) will shrink up to 50-60% of the pre-treatment volume. Women reported feeling lighter and less pressure.

How quickly can I go back to work?
Because the procedure is less invasive than surgery, the recovery time for UFE is much shorter than hysterectomy or myomectomy. Most women go back to work and normal activities in 7-10 days. On the other hand, recovery from an abdominal hysterectomy or myomectomy may take up to six weeks.

Can fibroids re-grow after UFE?
There are years of data available on patients who were followed up after UFE. It is rare for completely treated fibroids to re-grow. However, since UFE preserves the uterus, your body may develop new fibroids.  Less than 15% of women need repeat treatment for the same fibroids.

Will my heavy periods improve after UFE? / Will I still get a period after the procedure?
Most women notice a lighter flow at their next menstrual cycle and others may experience a lighter and shorter menstrual flow after 3-4 months.  A small number of patients have reported early onset menopause after the procedure, but this is not a common occurrence.

How soon after UFE can I have sex?
Patients may generally resume sexual activities in about a week.

Where can I get more information?
Your radiologists understand this treatment option and can provide in-depth consultations to help you make the best choice to effectively treat your fibroids and will work with your gynaecologist to provide the best treatment solution for your condition.