What Is a Uterine Fibroid Embolization ?
Uterine Fibroid Embolization (UFE), also known as Uterine Artery Embolization, is a minimally invasive procedure used to treat uterine fibroids without the need for major surgery. During the procedure, a specialist inserts a thin catheter through a small incision in the groin or wrist and guides it into the uterine arteries. Tiny particles are then injected to block the blood supply feeding the fibroids.
As a result, the fibroids shrink gradually, and symptoms such as heavy menstrual bleeding, pelvic pain, frequent urination, and abdominal pressure improve significantly. UFE is an excellent alternative to hysterectomy or myomectomy for women who wish to preserve their uterus and avoid open surgery.
Types of Abdominoplasty
Performed in slightly different ways depending on the site of catheter insertion, embolization material used, and patient's condition. Here are the main types:
Transfemoral UFE
The catheter is inserted through the femoral artery in the groin, which gives the doctor direct and easy access to the uterine arteries. It has been used for many years because of its success rate. However, patients may need to lie flat for several hours after the procedure to prevent bleeding from the puncture site.
Transradial UFE
The catheter is introduced through the radial artery in the wrist instead of the groin. This method is becoming more popular because it allows patients to move around sooner after the procedure and significantly improves comfort. The risk of groin complications is eliminated, and recovery is quicker.
Unilateral UFE
Sometimes, the doctor may choose to access and embolize only one uterine artery. This is usually done if one artery is sufficient to reach both sides or if accessing the other side is technically difficult. While this technique is less invasive, it may not always be as effective for women with multiple or very large fibroids, since complete fibroid shrinkage may require bilateral treatment.
Bilateral UFE
The most common and useful type of UFE, in which both uterine arteries are catheterised and embolised, is used. The fibroids become more uniform in the process of blocking both sides of the blood flow, and the risks of recurrence are minimised. This method usually works best in women who have more than one fibroid or a growth. It might require a little longer, but its outcomes are the most detailed.
1-2 Hours
Surgery Duration
Local Anesthesia
Anesthesia Used
When is Uterine Fibroid Embolization Recommended?
Uterine Fibroid Embolization (UFE) is a safe and minimally invasive option for women suffering from fibroids that affect their health, comfort, or quality of life. Doctors usually recommend UFE in the following situations:
Heavy or Prolonged Menstrual Bleeding
One of the most common reasons for UFE is menorrhagia (excessive menstrual bleeding). Women who experience bleeding so heavy that it interferes with daily life, causes anemia, or requires frequent pad/tampon changes may benefit from UFE. By shrinking fibroids, the procedure reduces bleeding and restores a more manageable menstrual cycle.
Pelvic Pain and Pressure Symptoms
Large fibroids can also compress the organs that surround them, causing chronic pain in the pelvis, bloat, or an overall sense of heaviness at the bottom of the belly. UFE shrinks these fibroids and reduces the pressure, alleviating the discomfort. This reinstates the ability of many women to sit, move and sleep at their own pleasure without feeling constant pelvic pressure.
Urinary and Bowel Problems
When fibroids grow large, they may push against the bladder or bowel, causing frequent urination, difficulty emptying the bladder, constipation, or rectal pressure. UFE reduces fibroid size, which in turn relieves these bladder and bowel-related symptoms, improving overall quality of life.
Rapidly Growing or Multiple Fibroids
Women who have multiple fibroids or fibroids that are growing quickly may be ideal candidates for UFE. Instead of removing each fibroid surgically, the procedure targets all fibroids at once by blocking their blood supply, making it especially effective for complex cases.
Fertility Preservation in Select Cases
Some women who still wish to conceive but are not suitable for open surgery may be considered for UFE. Although UFE is generally recommended for women not planning future pregnancies, in carefully selected cases, it can provide relief while preserving the uterus. The decision must be individualized after detailed counselling with a gynecologist.
Alternative to Hysterectomy or Myomectomy
For women who wish to avoid major surgery like hysterectomy (removal of the uterus) or myomectomy (surgical fibroid removal), UFE offers a less invasive alternative. It involves no large incisions, shorter recovery times, and fewer risks, making it an attractive choice for many patients.
Preparing for Uterine Fibroid Embolization Surgery Procedure
Preparing for your Uterine Fibroid Embolization surgery is a key part for a smooth surgery and a fast recovery.
Medical Evaluation & Pre-Procedure Tests
Before the procedure, your gynecologist and interventional radiologist will review your complete medical history and symptoms. Tests such as pelvic ultrasound or MRI are done to assess the number, size, and location of fibroids. Blood tests may also be ordered to check for anemia (due to heavy bleeding) and overall health. In some cases, a pregnancy test is also performed to rule out pregnancy before UFE.
Discussion of Treatment Options
Your doctor will explain the details of UFE, how it works, and whether it's the best choice compared to other options like hysterectomy or myomectomy. This discussion includes the benefits, possible risks, and long-term expectations, helping you make an informed decision.
Medication & Lifestyle Adjustments
- If you're taking blood-thinning medicines, aspirin, or NSAIDs, you may be advised to stop them a few days before the procedure to lower the risk of bleeding.
- Smoking should be stopped at least 2-4 weeks before the procedure since it delays healing and increases complications.
- Maintain a healthy diet rich in iron and vitamins if you've been experiencing heavy bleeding-related anemia.
Preparing at Home
Arrange for a family member or friend to accompany you to the hospital, as you won't be able to drive yourself home after the procedure. Prepare a comfortable recovery space at home with essentials like water, medications, light meals, and supportive pillows.
The Day Before & Day of Procedure
- Follow your doctor's instructions about fasting, usually no food or drink after midnight before the procedure.
- Bathe with antibacterial soap as advised, and avoid applying lotions or perfumes.
- On the day of the procedure, wear loose, comfortable clothing and leave jewelry at home.
What Happens During Uterine Fibroid Embolization Surgery?
UFE is a minimally invasive, image-guided procedure performed by an interventional radiologist. It blocks blood supply to fibroids, causing them to shrink and symptoms to improve.
- Preparation & Anesthesia: When you arrive at the hospital, you'll change into a gown and be taken to the procedure room. A mild sedative and local anesthesia will be given, this keeps you awake but relaxed, with no pain during the procedure. General anesthesia is rarely needed.
- Catheter Insertion: The radiologist makes a small puncture, usually in the groin (femoral artery) or the wrist (radial artery). Through this, a thin, flexible tube called a catheter is carefully guided into the uterine arteries using X-ray imaging for precision.
- Locating the Uterine Arteries: Contrast dye is injected through the catheter, which allows the radiologist to clearly see the blood vessels supplying the fibroids on a special X-ray screen (fluoroscopy). This step ensures accuracy before embolization.
- Embolization of Fibroid Arteries: Tiny particles (about the size of grains of sand) are then released through the catheter into the uterine arteries. These particles block the blood flow to the fibroids, while keeping blood supply intact for the uterus and surrounding tissues. Without blood flow, the fibroids gradually shrink over time.
- Treating Both Sides: The procedure is repeated on both the right and left uterine arteries to ensure complete treatment of all fibroids.
- Removal of Catheter & Bandaging: Once the embolization is done, the catheter is gently removed, and light pressure is applied to stop bleeding at the insertion site. A small bandage is placed, no stitches are required.
- Immediate Recovery: You'll stay in a recovery area for observation for a few hours. Some women may experience cramping, nausea, or mild pain, which is managed with medications. Most patients go home the same day or the following morning.
Who Performs the Uterine Fibroid Embolization
Uterine fibroid embolization is performed by interventional Radiologists, who are highly trained specialists in using imaging techniques to perform minimally invasive procedures.
Suppose you are experiencing symptoms of uterine fibroids and are interested in exploring non-surgical treatment options. In that case, it's advisable to contact an interventional radiologist or get a referral from your primary care physician or gynecologist.
Recovery After Uterine Fibroid Embolization Surgery Procedure
Healing after UFE is a gradual process, and while most women return to normal life quickly, understanding the recovery timeline helps set realistic expectations.
First Few Days After the Procedure
- It's normal to feel pelvic cramping, mild to moderate pain, fatigue, or nausea in the first 24-48 hours. These are signs of your fibroids losing blood supply and beginning to shrink.
- Pain and discomfort are managed with prescribed medications, and many women also benefit from heating pads for cramps.
- Rest is key during this time. Avoid strenuous activities and try to stay hydrated.
Doctor's Tip: "Mild pain and cramping are expected, don't panic. Stick to your medication schedule rather than waiting for discomfort to peak."
Week 1 to 2
- By the end of the first week, most women notice significant improvement in pain and energy.
- You can return to light daily activities like walking around the house, desk work, or cooking simple meals.
- Some women may experience a mild fever or vaginal discharge, which is part of the healing process.
Doctor's Tip: "Listen to your body. If fever goes above 101°F, or you notice heavy bleeding, contact your doctor immediately."
Weeks 3 to 4
- Energy levels improve further, and normal activities, including work, can usually be resumed.
- Fibroids begin shrinking, so symptoms like heavy periods, pressure, or urinary frequency start showing improvement.
- Light exercise, such as yoga, stretching, and longer walks, can be resumed, but avoid heavy lifting or intense workouts.
Doctor's Tip: "Your uterus is healing inside even if you feel fine. Gradually increase activity instead of rushing back to full exertion."
3 to 6 Months Post-Procedure
- Fibroids continue to shrink over time, leading to lighter periods, less pelvic pain, and reduced bloating or pressure.
- Fertility outcomes vary, while some women go on to conceive successfully, UFE is not typically recommended for those primarily seeking pregnancy.
- At this stage, you'll notice the full benefits of UFE with restored comfort and improved quality of life.
Doctor's Tip: "UFE results are progressive. Patience is key, the shrinking process continues for months, with most women reporting lasting relief."
Lifestyle Changes After UFE
- Avoid heavy lifting and strenuous activity for at least a week.
- Stay hydrated and eat a balanced diet to promote recovery.
- Use prescribed pain medications to manage post-procedure cramping.
- Monitor for fever, unusual discharge, or severe pain and report to your doctor immediately.
Benefits of Uterine Fibroid Embolization Surgery
UFE reduces heavy bleeding, pelvic pain, and pressure symptoms while preserving the uterus and offering a minimally invasive alternative to surgery.
- Minimally Invasive Approach: Unlike open surgery, UFE is done through a tiny puncture in the skin, which means no large incisions, less scarring, and faster recovery.
- Effective Symptom Relief: Most women experience significant improvement in heavy bleeding, pelvic pressure, and pain within weeks to months.
- Preserves the Uterus: UFE treats fibroids without removing the uterus, making it a good option for women who wish to avoid hysterectomy.
Quick Recovery Time: Patients often return to work and normal activities within 1-2 weeks, much faster than traditional surgery.
- Lower Risk of Complications: Since it avoids major surgery, risks of infection, excessive blood loss, or long hospital stays are reduced.
- Long-Term Results: Many women experience lasting relief as fibroids shrink and symptoms improve progressively over months.
Risks of Uterine Fibroid Embolization Surgery
Potential risks include infection, premature menopause, allergic reaction to contrast dye, pelvic pain, or incomplete fibroid shrinkage.
- Post-Embolization Syndrome: Some women develop mild fever, pain, and nausea in the first few days after the procedure, which usually resolves with medications.
- Infection: Though rare, infection of the uterus or fibroids can occur and may require antibiotics or, in severe cases, surgery.
- Impact on Fertility: UFE is not recommended for women who are planning to conceive, as it may affect fertility or pregnancy outcomes.
- Incomplete Fibroid Shrinkage: While most fibroids shrink significantly, some may not reduce enough, and symptoms could persist or recur.
- Possible Menstrual Changes: Some women may notice lighter or irregular periods; in rare cases, early menopause can occur, especially in women over 45.
- Rare Complications: Damage to nearby organs, blood clots, or allergic reactions to contrast dye are uncommon but possible.
What is the Cost of Uterine Fibroid Embolization in India?
The cost of UFE can vary depending on factors such as hospital facilities, doctor's expertise, diagnostic tests, and post-procedure care it can range from Rs. 70,000 to Rs. 2,00,000.
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