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UCLA Fibroid Treatment Program

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Uterine Artery/Fibroid Embolization

Uterine Fibroid Embolization (UFE) or Uterine Artery Embolization (UAE) has proven successful in significantly decreasing or eliminating fibroid related symptoms of bleeding, pressure and pain in women with uterine fibroids. Uterine Fibroid Embolization is a minimally-invasive alternative to surgery. This procedure preserves the uterus. An interventional radiologist carefully places a small catheter into the uterine arteries and inserts small particles that block the blood supply to the fibroids, causing the fibroids to shrink. This treatment takes 1 to 2 hours and is an outpatient procedure (can stay overnight if done late in the day). The procedure does not require general anesthesia and recovery time is significantly reduced compared with surgical alternatives. This procedure has been done for 20 years and is FDA approved for women with symptomatic uterine fibroids and adenomyosis.

Example of Uterine Fibroid
Image of Uterine Fibroids. Uterine Artery Embolization; pre-treatment and post-treatment. UCLA Uterine Fibroid Program.
(A) Pre-treatment.                         (B) Post-treatment

What is Uterine Fibroid Embolization?

Uterine fibroid embolization, is a minimally invasive procedure that is performed by an Interventional Radiologist. An Interventional Radiologist is a medical doctor who has extensive experience in diagnostic and vascular radiology and uses imaging to guide therapeutic procedures. The physician accesses the arteries supplying the fibroids through a small catheter and administers small particles called microspheres. The microspheres block the vessels to the fibroids, depriving them of blood. The lack of blood results in the fibroids shrinking. The microspheres remain permanently in the blood vessels at the fibroid site.

What should I experience during the treatment?

The entire fibroid treatment lasts one to two hours, and is performed as an outpatient therapy. Patients can stay up to 23 hours after the procedure is complete but usually leave earlier. The uterine fibroid embolization procedure begins with a tiny nick in the wrist or the groin. This small opening provides the interventional radiologist with access to the femoral artery in the upper thigh or the radial artery in the wrist. Using specialized X-ray equipment, the doctor passes a catheter (small tube) into the uterine artery, and guides it toward the uterus. When the doctor has reached the location of the fibroids, microspheres (small spheres) are injected through the catheter and into the artery leading to the uterine fibroids.

The catheter is then moved to the other side of the uterus using the same small opening in the thigh or wrist. Once the Interventional Radiologist has completed embolization of the uterine artery on both sides, the catheter is gently removed. Pressure is applied to the puncture site for a few minutes to prevent any bleeding and then a small Bandage is placed.

Once the procedure is complete, you may experience some discomfort such as abdominal cramping or pain. You and your doctor will determine what medications may be needed to keep you comfortable.

Life after the Treatment

85-90 percent of women who have had the procedure experience significant or total relief of heavy bleeding, pain and/or bulk-related symptoms. The procedure is effective for multiple fibroids, including large fibroids. Recurrence of the treated fibroids is very rare.

FAQ

What types of fibroids can be treated?

Your physician will determine if your fibroids are suitable for treatment. Uterine Fibroid Embolization can be used for submucosal, subserosal, and intramural uterine fibroids. These are terms that are used to describe the location of the fibroid within the uterus. Fibroids that are pedunculated (hanging from a stalk) can be treated as well. Essentially all other fibroid types can be effectively treated with Uterine Fibroid Embolization. Multiple fibroid are treated in one session.

Could my fibroids come back after the treatment?

Although this treatment may be successful in destroying the fibroids, years later, new fibroids may grow, become symptomatic and require additional treatment. This is true for all fibroid treatments, except hysterectomy where the entire uterus is removed. However, since fibroids grow very slowly, repeat treatments are usually not required. Long term data demonstrates that more than two thirds of UAE patients do not need further intervention as measured at 10 years (EMMY trial).

What are the benefits of Uterine Fibroid Embolization?
  • Effective alternative to surgery and hormonal treatment
  • Minimally invasive - no surgery
  • Minimal hospital outpatient stay
  • Quick return to normal activities
  • Preserves the uterus, cervix and ovaries
  • Significant improvement in your quality of life
What are the benefits of going through the wrist rather than the groin?

The wrist or transradial approach can improve the patient experience because entry into the body is more comfortable and convenient. With the transradial approach, you are able to sit up and move around immediately after the procedure is complete, whereas with the femoral approach you must lie flat on your back for at least several hours after the procedure. Also, you will be able to get out of bed to use the toilet and no Foley catheter is placed.

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