What are fibroids?
Fibroids are growths that develop in the womb, also called the uterus. They are not cancer. Even though 20-40% of women have fibroids, most do not notice them.
Around 30% of women with fibroids have symptoms. Fibroids can bleed or press on other organs. When they do, they can cause heavy periods, pain in the pelvis, frequent need to urinate, constipa- tion, or difficulty getting pregnant. Women who suffer from fibroid-related symptoms may seek treatment to shrink or remove their fibroids.
What is UFE?
Uterine Fibroid Embolization (UFE) is a minimally invasive procedure to shrink fibroids. After numbing the skin, the clinician passes a tiny plastic tube into an artery in the wrist or upper thigh. The clinician then uses moving x-rays to guide the tube into the arteries that feed the fibroids. The clinician then injects tiny particles to block off the blood supply to the fibroids. Without blood, the fibroids shrink over time. UFE is 80-95% effective.
Patients usually go home the same day or next day. Most return to work in a few days to a week.
Uterine Fibroid Embolization Procedure
1. After numbing the skin, the clinician puts a small tube into the artery at the top of the wrist (shown) or thigh.
2. Using x-ray guidance, the clinician steers the small tube to the artery that feeds the fibroids.
3. They inject tiny beads into the blood vessels that feed the fibroids. The fibroids shrink over weeks.
What are the risks?
UFE is a safe procedure. Most patients will have some pain, cramping, nausea, or fatigue within the first 24 hours. These symptoms usually improve over several days. Rarely, they can last up to a month.
There is a 3 in 100 risk of passing bits of fibroid through the vagina.
The ovaries can be affected, and there is a 6 in 100 risk of developing temporary menopause symptoms. UFE may affect a woman’s ability to get pregnant. Injuries to other organs in the pelvis are rare.
Fibroids can come back in 5-10 in 100 women in the first year after UFE. These women can be treated again.
Rarely women can develop a serious infection (less than 1 in 100 women).
Blood clots are extremely rare (1 in 400 women).
What are the alternatives?
Your treatment options depend on your symptoms and the number, size, and location of your fibroids.
Alternative 1 No treatment. Not all fibroids need to be treated. Some fibroids may shrink naturally after menopause.
Alternative 2 Medicines. Birth control pills and other medicines can make some fibroids shrink enough to improve symptoms. Medicines are a common first choice, but 3 in 5 women who choose them will need another treatment within two years.
Alternative 3 Surgery. “Hysterectomy” is a surgery to remove the uterus. Fibroids do not come back after hysterectomy. However, it has the highest risks and longest recovery time. Pregnancy is not possible after hysterectomy, and some women develop pelvic floor weakness. A “myomectomy” is a surgery to remove the fibroids without removing the uterus. Recovery may be easier, but the fibroids can come back.
Frequently asked questions
My doctor just told me I have fibroids. What's that?
A fibroid is a growth in the uterus.
Fibroids are not cancer.
The medical term is leiomyoma.
Can I get fibroids?
You can’t catch them like a cold. No one really knows what causes them, but 1 in 3 women between the ages of 18 and 50 in the U.S. will get one or more fibroids. It is even more common for women of certain ethnic backgrounds.
How would I know if I have fibroids?
Some women do not know they have fibroids. For others, fibroids can cause symptoms, such as:
Heavy periods
Bleeding between periods
Pelvic pain or discomfort
Having to go to the bathroom often
Pain or discomfort during sex
Are fibroids dangerous?
Fibroids can cause too much blood loss. Too much blood loss can lead to a serious medical condition called anemia, or low blood counts.
If I have a fibroid, what should I do?
Many women have fibroids that never cause any problems. Fibroids usually shrink on their own after menopause. However, if you have symptoms related to your fibroids, you should see a doctor.
Who should I see?
Most women with fibroids end up first seeing a gynecologist, or “OB-GYN,” who may offer surgery. A hysterectomy is a surgery to remove the entire uterus. Future pregnancy is not possible. A myomectomy is a surgery to remove the fibroid but leave the uterus.
What if I don't want surgery? Are there other options?
Yes! There are several alternatives to surgery for the treatment of fibroids. The one with the best results is a MIIP called uterine fibroid embolization or “UFE.” It is performed by a specialist called an interventional radiologist, or “IR.”
UFE? What's that?
After numbing the skin, the Interventional Radiologist puts a small plastic tube through a pinhole and into an artery in either the arm or groin. The IR then uses moving x-rays to guide the small tube into the arteries in the pelvis that supply blood to the fibroids. The IR then injects tiny particles to block off the blood supply to the fibroids to make them shrink over time.
Will I be awake during the procedure?
Many women do fine being awake during the procedure with
just the numbing medication. Some women opt for medicine to make them drowsy.
Will it hurt?
The numbing medicine may sting for a few seconds but, after that, the procedure itself does not hurt. After the procedure successfully cuts off the blood supply to the fibroids, most women experience pelvic pain that can be controlled with medicine. This pain can be anywhere from mild to severe and usually lasts several hours, sometimes longer. Other symptoms may include nausea, vomiting, fever, and chills. These symptoms can usually be controlled with medicine.
Do I have to stay in the hospital afterwards?
The symptoms after UFE are best controlled in the hospital, so most women stay overnight and go home the next day. By comparison, most women who have surgery stay in the hospital several days to a week.
How long until I can get back to my normal life?
You can expect to feel well enough to go back to work and other regular activities in 1-2 weeks. By comparison, recovery from surgery can take several months.
Is it safe?
Yes. Interventional Radiologists are specially trained to perform this MIIP and do it safely. The chance of a major complication happening in experienced hands is less than 1 in 100. By comparison, 10 women out of every 100 undergoing surgery have a major complication.
Can I get pregnant after UFE?
It is possible to get pregnant after UFE. The chances of pregnancy after UFE are similar to the chances after myomectomy. Remember that it is not possible to get pregnant after hysterectomy.
What if it doesn't work?
Nine out of 10 women who have a UFE experience relief from their fibroid symptoms. Sometimes the fibroids do not respond completely or can grow back. Fortunately, UFE can usually be performed again.
Where can I learn more about UFE?
Ask your primary care doctor or OB-GYN about UFE and for a referral to an IR.
You can also look for an Interventional Radiologist in your area at sirweb.org
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