Uterine Artery Embolization Side Effects

To understand the potential uterine artery embolization side effects, it helps to first have an appreciation for how the procedure modifies the body. The uterine artery embolization procedure begins with your fibroid specialist creating a small puncture in your groin or in your arm. This puncture is used to pass a catheter into your vascular system and thread it into your uterine arteries via real-time imaging. Once the catheter is in position, micro-sized beads are injected into the artery that supplies blood to the fibroid. The beads work by blocking blood flow and cutting off the fibroid’s blood supply, causing the fibroids to shrink. Most side effects of uterine artery embolization stem from the introduction of a foreign body (the beads) into the fibroid vasculature, but the puncture site can also be a source of post-operative discomfort, as we explain further below.

The most common uterine artery embolization side effects include pelvic pain, cramping, and temporary bleeding. Almost every patient experiences these side effects as they recover from the procedure. Less common side effects include post-embolization syndrome (pain, nausea, mild fever, flu-like symptoms), hot flashes, vaginal discharge, fibroid expulsion, and bruising at the puncture site. While still somewhat common, not every patient experiences these less common side effects.

Finally, rare side effects of uterine artery embolization include vaginal infection, urinary tract infection (UTI), urinary retention, urinary incontinence, thigh paresthesia, absence of menstruation, uterine artery damage, and uterine artery thrombosis (clotting). These rare side effects are also referred to as uterine artery embolization complications because they’re unexpected, uncommon problems that can require additional medical treatment to resolve. Uterine artery embolization complications occur in less than 1% of treated individuals, and this figure is based on data from about 10 years ago when operators were generally less experienced than they are today. [1]

In most cases, uterine artery embolization side effects are inconsequential and tend to resolve on their own within the first 30 days following the procedure.

In addition to continued bleeding, some women will have a clear watery vaginal discharge for multiple weeks or months following uterine artery embolization. This does not indicate an infection unless the discharge is thick, colored, or has a foul-smelling odor (see Uterus Infection below).

Depending on the location of the fibroid, treatment with uterine artery embolization can detach the fibroid and cause it to eject from the vagina. Fibroid expulsion discharge is often accompanied by heavy bleeding, and the affected fibroid takes on the appearance of a bloody clot or a clump of tissue.

Fever, chills, and a foul-smelling discharge after UAE are potentially indicative of the uterus being infected. This can occur when a treated fibroid becomes necrotic following embolization, which is why it is sometimes referred to as necrotic fibroid odor. Patients that experience these symptoms are advised to seek immediate medical attention. A routine postoperative infection is usually treated with simple oral antibiotics, while a more severe infection may require hospitalization for IV administered fluids and antibiotics.

We included infertility and pregnancy uterine artery embolization complications in this list because it shows up on many other credible sources, but this shouldn’t necessarily be taken at face value. The debate over whether or not uterine artery embolization has a negative impact on fertility or pregnancy outcomes is still ongoing, and neither side of the argument has the upper hand from an evidence-based perspective. Check out our recent article on uterine artery embolization and pregnancy to learn more.

Long-term side effects of fibroid embolization include are nontarget embolization, thigh paresthesia, thrombosis, urinary retention, urinary incontinence, and the absence of menstruation. However, long-term side effects of fibroid embolization are quite rare and are often associated with procedural complications.

As we discussed above, the most common uterine artery embolization side effects are short-lived and self-limiting, meaning that they resolve on their own without treatment. Pelvic pain, bleeding, bruising, hot flashes, and discharge fall into this category. Other side effects are managed with basic medical treatments, such as post-embolization syndrome and infections, but with the proper medical attention, these are also resolved shortly after they present.