Uterine Fibroid Embolization
What is uterine fibroid embolization?
Uterine fibroid embolization is a procedure to shrink noncancerous tumors called uterine
fibroids in the wall of the uterus. It does not use major surgery, so you may recover
faster. You also may not need to stay in the hospital.
Uterine fibroid embolization shrinks fibroids by blocking off their blood supply.
The doctor injects very small particles (about the size of sand grains) into the arteries
that supply the fibroids. The particles stick to the vessel wall. This causes a clot
to develop that blocks off the blood supply. Once the blood supply is gone, the fibroids
shrink. Your symptoms usually ease or go away over time.
Several types of particles are used for uterine fibroid embolization. These substances have safely
been used by doctors for many years.
The procedure is done by a doctor called an interventional radiologist. This doctor
specializes in treating conditions without using major surgery. Instead they use small
tools plus imaging tests. These tests include X-rays, CT scans, MRI, fluoroscopy,
or ultrasound. These may be used before, during, or after the procedure.
Why might I need a uterine fibroid embolization?
The main reason to have a uterine fibroid embolization is to treat uterine fibroid
tumors that are causing pain, too much vaginal bleeding, or other problems. Nearly
all fibroid tumors are not cancer (benign). It's rare to have a cancerous fibroid.
Not all the fibroids are diagnosed, because they are too small. The fibroids can range
from the size of a pea to as large as a softball or small grapefruit. Uterine fibroid embolization
may not be advised if your fibroids are very large.
Your healthcare provider may recommend this procedure if you have fibroids causing:
Low blood count (anemia) from uterine bleeding
Fullness or pain in your belly
An enlarged uterus
Belly that is larger than normal
Bladder pressure that makes you feel like you need to urinate often
Pressure on the bowel that causes constipation and bloating
Pain during sex
Pain in your back or legs, which may be caused by the fibroids pressing on nerves
Your healthcare provider may have other reasons to recommend a uterine fibroid embolization.
What are the risks of a uterine fibroid embolization?
Any procedure can have complications. Possible complications of this procedure include:
Abnormal bleeding (hemorrhage)
Injury to the uterus
Infection of the uterus or the puncture site in the groin
Collection of blood under the skin (hematoma) at the puncture site in the groin
Injury to the artery being used or nearby structures
Infertility or problems with a future pregnancy
Loss of menstrual periods (amenorrhea)
Allergic reaction to contrast or other medicines that may be given
Some women have postembolization syndrome. Symptoms include:
Pelvic pain and cramping
Nausea and vomiting
Fatigue and discomfort
Symptoms of postembolization syndrome may last 2 to 7 days. It's treated with pain
medicines and anti-inflammatory medicines. Medicine to help with nausea may also be
Some women will go through menopause after the procedure. This is especially true
for women older than age 45.
The uterus is not removed during uterine fibroid embolization. So you could still
have a baby. But more research is needed to find out how this procedure might affect
fertility and pregnancy.
You may have other risks that are unique to you. Discuss any concerns with your healthcare
provider before the procedure.
How do I get ready for a uterine fibroid embolization?
Your healthcare provider will explain the procedure to you. Ask them any questions
you have about the procedure.
You will be asked to sign a consent form that gives permission to do the procedure.
Read the form carefully and ask questions if anything is not clear.
You may need a physical exam before the procedure to make sure you are in good health.
You may also need blood tests or other tests.
Follow any directions you are given for not eating or drinking before the test.
Tell your healthcare provider if you are pregnant or think you may be pregnant.
Tell your healthcare provider if you are allergic to contrast dye or iodine.
Tell your healthcare provider if you are sensitive to or are allergic to any medicines,
latex, tape, or local and general anesthesia.
Tell your healthcare provider about all medicines you are taking. This includes prescriptions,
over-the-counter medicines, and herbal supplements.
Tell your healthcare provider if you have had a bleeding disorder. Also tell your
healthcare provider if you are taking blood-thinning medicine (anticoagulant), aspirin,
or other medicines that affect blood clotting. You may need to stop these medicines
before the test.
You will be given medicine to help you relax and a local pain medicine at the groin
You should arrange for someone to help around the house for a day or two after the
Follow any other instructions your healthcare provider gives you to get ready.
What happens during a uterine fibroid embolization?
You may have uterine fibroid embolization as an outpatient, or you may need to stay
overnight in a hospital. The way the test is done may vary depending on your condition
and your healthcare provider’s practices.
Generally, a uterine fibroid embolization follows this process:
You will be asked to remove any jewelry or other objects that may get in the way of
You will be asked to remove clothing. You will be given a gown to wear.
An IV (intravenous) line will be started in your arm or hand.
You may be given antibiotic medicine before the procedure.
You will lie on your back on the procedure table.
The doctor will put a long, thin tube (catheter) into your bladder to drain urine.
Medical staff will watch your heart rate, blood pressure, breathing, and blood oxygen
level during the procedure.
The doctor will clean the groin area with an antiseptic solution.
The doctor will put a small tube (sheath) into your groin area. This will be used
as a guide to put the catheter in the arteries to be blocked off (embolized).
The doctor will inject contrast dye into the catheter. The contrast dye will help
the doctor find the artery to be blocked off. The doctor will use X-rays to help find
the blood vessels that supply blood to each fibroid.
The doctor will put a tiny catheter into the groin (femoral artery) and move it into
the arteries that need to be blocked. They will inject very small particles into the
The doctor will take more X-ray images to make sure the arteries are blocked.
Some doctors will use one groin site to treat both the left and right uterine arteries
if needed. Other doctors may use two groin sites.
The sheath and catheter will be removed after the embolization is done.
What happens after a uterine fibroid embolization?
In the hospital
Medical staff will put pressure on the insertion site in the groin to stop bleeding.
This usually takes about 20 minutes.
You will then be taken to the recovery room. Staff will watch your blood pressure,
pulse, and breathing. You will need to lie flat for a few hours. Your recovery process
will vary depending on the type of medicine used to help you relax. Once your vital
signs are stable and you are alert, you will be taken to your hospital room or sent
You may have cramping in your belly after the procedure. You may get pain medicine
given by a nurse or through a device connected to your IV line.
You may have small to moderate amounts of fluid draining from your vagina for several
days. The nurse will check the sanitary pads to see how much drainage you have.
You will be encouraged to get out of bed after you have rested and your groin puncture
site has sealed. You should also do coughing and deep breathing exercises as your
nurse tells you to.
You may be given liquids to drink a few hours after the procedure. Your diet may be
gradually changed to more solid foods as you are able to eat them.
Once you are home, it's important to keep the groin incision clean and dry. Your healthcare
provider will give you specific bathing instructions. If adhesive strips are used,
they should be kept dry. They usually will fall off within a few days.
You may have aching at the incision site and in your abdominal and pelvic muscles.
This is especially true after you stand for long periods. Take a pain reliever for
soreness as recommended by your doctor. Aspirin or certain other pain medicines may
increase the chance of bleeding. Be sure to take only recommended medicines.
Your doctor will probably recommend walking and limited movement. You will likely
need to avoid strenuous activity. Your doctor will tell you when you can go back to
work and resume normal activities.
Make sure to include fiber and plenty of fluids in your diet. This will help keep
you from getting constipated. Straining to have a bowel movement may cause problems.
Your doctor may recommend a mild laxative.
You should not use a douche or tampons or have sex until your healthcare provider
says you can do so. Also, don't go back to work until your healthcare provider says
it is OK.
Tell your healthcare provider if any of these occur:
Fever or chills
Redness, swelling, or bleeding or other fluid drains from the incision site
Increased pain around the incision site
Abdominal pain, cramping, or swelling
Increased vaginal bleeding or passing of tissue or other drainage
You will need to see your healthcare provider for a follow-up visit. This is usually
1 to 2 weeks after the procedure. At that time, the doctor may schedule an ultrasound
or MRI in 6 months to see how well the procedure worked.
Your healthcare provider may give you other instructions, depending on your situation.
Before you agree to the test or the procedure, make sure you know:
The name of the test or procedure
The reason you are having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you are to have the test or procedure
Who will do the test or procedure and what that person’s qualifications are
What would happen if you did not have the test or procedure
Any alternative tests or procedures to think about
When and how you will get the results
Who to call after the test or procedure if you have questions or problems
How much you will have to pay for the test or procedure