Uterine Artery Embolization Side Effects
What to Expect After Your UAE Procedure
Some long term and short term uterine artery embolization side effects are experienced by virtually every patient while other UAE side effects are quite rare and potentially quite severe. In general, uterine artery embolization is a very safe procedure with a very low complication rate, but women who opt into the procedure should still understand the risks and what they can expect during their recovery.
To help you prepare for your uterine artery embolization procedure, our Fibroid Specialists break down the possible uterine artery embolization long term and short term side effects, explain why they occur, and also provide context on how common or rare they are.
Uterine Artery Embolization Specialist in Los Angeles
“I did quite a lot of research about my options after learning I had 2-3 fibroids, one being almost 10cms in size. It was frightening to know that if it got any larger, I wouldn’t be able to do a myomectomy. I started finding out about the UFE and how it was far less invasive. I decided to get it done with Dr. Lalezarian and it went extremely well! The first couple of days after were difficult but once that passed, I have been feeling so much better overall, and my cycles have been far less strenuous. I would recommend it for anyone who is struggling to make a decision and wants to do something minimally invasive. You are in good hands with Dr. Lalezarian, who is a caring and attentive person to have supporting you!”
Elizabeth S, February 2022
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.
Uterine Artery Embolization Side Effects
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.
Pelvic Pain
Very Common
Bleeding
Very Common
Post-Embolization Syndrome
Hematoma (Bruising)
Hot Flashes
Vaginal Discharge
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).
Fibroid Expulsion Discharge
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.
Uterus Infection
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.
Urinary Tract Infection (UTI)
Rare
Urinary Retention
Rare
Urinary Incontinence
Absence of Menstruation
Thrombosis
Thigh Paresthesia
Nontarget Embolization
Infertility and Pregnancy Complications
We included infertility and pregnancy 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
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.
Surgical vs. Non-Surgical Fibroid Treatments: Which Is Best?
When it comes to fibroid treatment, we believe that less is more. A less invasive procedure means less trauma, less risk, and shorter recovery time. Learn more about why we opt for UFE, the least invasive treatment for uterine fibroids.
Uterine Artery Embolization & Pregnancy: Risks, Complications, Clinical Evidence
Fibroid Specialist in Los Angeles
Learn more about Los Angeles Fibroid Specialist Dr. Michael Lalezarian.
[1] Gupta et al. (2014). Uterine artery embolization for symptomatic uterine fibroids (Review). Cochrane Library, (5). http://doi.org/10.1002/14651858.CD005073.pub4.
[2] Hehenkamp, W. J. K., Volkers, N. A., Donderwinkel, P. F. J., De Blok, S., Birnie, E., Ankum, W. M., & Reekers, J. A. (2005). Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids (EMMY trial): Peri- and postprocedural results from a randomized controlled trial. American Journal of Obstetrics and Gynecology, 193(5), 1618–1629. http://doi.org/10.1016/j.ajog.2005.05.017
[3] Moss, J. G., Cooper, K. G., Khaund, A., Murray, L. S., Murray, G. D., Wu, O., … Lumsdenf, M. A. (2011). Randomised comparison of uterine artery embolisation (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST trial): 5-Year results. BJOG: An International Journal of Obstetrics and Gynaecology, 118(8), 936–944. http://doi.org/10.1111/j.1471-0528.2011.02952.x
[4] Manyonda, I. T., Bratby, M., Horst, J. S., Banu, N., Gorti, M., & Belli, A. M. (2012). Uterine artery embolization versus myomectomy: Impact on quality of life – Results of the FUME (Fibroids of the uterus: Myomectomy versus embolization) trial. CardioVascular and Interventional Radiology, 35(3), 530–536. http://doi.org/10.1007/s00270-011-0228-5
[5] Mara, M., Maskova, J., Fucikova, Z., Kuzel, D., Belsan, T., & Sosna, O. (2008). Midterm clinical and first reproductive results of a randomized controlled trial comparing uterine fibroid embolization and myomectomy. CardioVascular and Interventional Radiology, 31(1), 73–85. http://doi.org/10.1007/s00270-007-9195-2
[6] Schirf, B. E., Vogelzang, R. L., & Chrisman, H. B. (2006). Complications of Uterine Fibroid Embolization, 1(212), 143–149. http://doi.org/10.1055/s-2006-941444.
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