Uterine Fibroid Embolization (UFE):what to expect

Your doctor may suggest UFE if you have:

• Exceptionally heavy, prolonged, or abnormal menstrual bleeding.
• Severe pelvic pain or debilitating cramps during your period.
• A feeling of pressure, swelling, or bloating in your lower abdomen.
• Pain during sexual intercourse.
• Frequent urination or constipation caused by a large fibroid pressing on your bladder or bowel.

You will not feel pain during the procedure due to the local numbing medication and IV sedation. However, after the procedure, as the fibroids begin to lose their blood supply, you will experience moderate to severe pelvic cramps. For most patients, these cramps are the most intense during the first three days and feel like a very heavy menstrual cycle. Your care team will provide you with strong pain relief medications to keep you comfortable at home.

You will need to fast for several hours before the procedure because you will receive relaxing IV sedation. Your doctor will also likely order an MRI or ultrasound beforehand to map out exactly where your fibroids are.

You will lie on an exam table under an X-ray machine. The doctor numbs your wrist or groin and inserts a tiny tube into the artery. Using the live X-ray screen for guidance, they steer the tube to the arteries supplying the uterus. Tiny particles are then injected to block the blood flow specifically going to the fibroids, causing them to shrink and die over time.

Procedure and recovery time vary. Some patients go home the same day, while pain, nausea, bleeding, comorbidity, or local protocol may require overnight observation or admission.

Interventional radiology is minimally invasive, but it is not risk-free and is not automatically safer or more effective than surgery, endoscopy, medicines, or observation for every patient. Technical success does not always produce symptom relief or cure disease, and repeat treatment or another approach may be needed. Suitability depends on anatomy, disease severity, comorbidities, imaging, local expertise, and the alternatives available.

Risks vary by procedure and may include pain, bleeding, infection, contrast reaction, kidney injury, radiation exposure, vessel or organ injury, clotting, device movement or blockage, sedation complications, treatment failure, and an unplanned operation or admission. Tissue sampling can be nondiagnostic and requires pathology; tumor treatments require oncology follow-up. The consent discussion should cover the patient-specific benefits, material risks, alternatives, and what happens if the procedure cannot be completed.

Preparation is individualized. Give the team a complete list of anticoagulants, antiplatelet drugs, diabetes medicines, supplements, allergies, kidney problems, pregnancy possibility, and prior contrast reactions. Do not stop a blood thinner or diabetes medicine on your own: the procedural team and prescribing clinician must balance bleeding against thrombosis or metabolic risk and provide exact written instructions. Fasting, laboratory tests, antibiotics, sedation, escort, admission, and aftercare differ by procedure.

• CIRSE: Interventional-radiology procedures
• CIRSE: Clinical Practice Manual
• American College of Radiology: Manual on Contrast Media

UFE can improve bleeding and bulk symptoms for many appropriately selected patients, but fibroids may persist or recur and further treatment can be needed. Infection, expulsion, ovarian dysfunction, amenorrhea, nontarget embolization, and uncertain implications for future fertility and pregnancy require individualized discussion against myomectomy, hysterectomy, medicines, and observation.