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Uterine Artery Embolization Side Effects

What to Expect After Your Procedure

Woman lying in bed with uterine artery embolization side effects

Side effects refer to the undesired secondary effects of a medical treatment or procedure. Some side effects of uterine artery embolization are experienced by virtually every patient while other 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 side effects, explain why they occur, and also provide context on how common or rare they are.

Fibroid Specialist Dr. Lalezarian provides fibroid symptom relief in Los Angeles, California

Uterine Artery Embolization Specialist in Los Angeles

ProFibroidMD is a leading provider of uterine fibroid embolization (UFE), the least invasive treatment option for uterine fibroid symptom relief. Our Fibroid Specialists have helped countless women overcome their fibroids and get back to their happy, healthy selves.
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To understand the potential side effects of uterine artery embolization, 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 side effects of uterine artery embolization 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 complications of uterine artery embolization because they’re unexpected, uncommon problems that can require additional medical treatment to resolve. 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, the side effects of uterine artery embolization are inconsequential and tend to resolve on their own within the first 30 days following the procedure.

Pelvic Pain

Very Common

Uterine artery embolization works by blocking blood flow to the fibroids, and can therefore activate pain signals that respond to oxygen deficiency in the organ. Patients typically describe this as a cramping pain around the site of treatment that sets in as analgesics wear off and continues for a few days after the procedure. Pain typically lasts for 3-4 days, and less frequent cramping pain can occur for up to 2 weeks following the procedure. Many doctors will prescribe post-procedural NSAIDS like ibuprofen that patients are required to take for the first 5 days following uterine artery embolization. Additional pain control with oxycodone for the first 48 hours may be prescribed as well depending on the patient’s pain levels.

Bleeding

Very Common

Bleeding after uterine fibroid embolization varies from person to person. Some women experience no extra bleeding outside of their normal menstrual cycle, and some women notice a reduction in bleeding immediately following the procedure, but others are surprised to learn that their bleeding continues even after a successful procedure. For these women, cycles should become increasingly lighter in the months following the embolization procedure as the fibroids shrink. If uterine artery embolization is successful, women will re-establish a new baseline cycle after 4-6 months, which should be much lighter and closer to their normal cycle before fibroids.

Post-Embolization Syndrome

Common
Post-embolization syndrome describes a set of symptoms that can occur when a foreign body is injected into the arteries. Patients with post-embolization syndrome experience pain, nausea, mild fever, and flu-like symptoms. These symptoms are not exclusive to uterine artery embolization, and are known to occur following other embolization therapies. Patients are advised to take Tylenol for fevers if they’re able to.
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Woman experiencing uterine artery embolization side effects

Hematoma (Bruising)

Common
It’s common for bruising to develop at the puncture site. Bruising will typically go away on its own in the weeks following the procedure.

Hot Flashes

Somewhat Common
Some women experience hot flashes or night sweats for up to a few weeks following uterine artery embolization. These symptoms typically resolve on their own without additional treatment.

Vaginal Discharge

Somewhat Common
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 odor (see Uterus Infection below).

Fibroid Expulsion

Rare
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 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

Rare
Fever, chills, and a foul-smelling vaginal discharge are potentially indicative of the uterus being infected. This can occur when a treated fibroid becomes necrotic following embolization. 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

Infection in the urinary tract is also possible after uterine artery embolization. Women who experience UTI symptoms following embolization should seek immediate medical attention.

Urinary Retention

Rare

Though rare, women can have difficulty urinating as a consequence of uterine artery embolization. When successful, uterine artery embolization is actually associated with improved urinary symptoms, but the opposite outcome has been observed in a small percentage of the treated population in clinical studies.

Urinary Incontinence

Very Rare
Urinary incontinence (difficulty holding in urine) is also possible after uterine artery embolization, though equally rare to urinary retention.

Absence of Menstruation

Very Rare
Abnormal menstruation patterns have been reported in a small subset of the treated population following uterine artery embolization. When this does occur it’s usually temporary. However, a few cases of early onset menopause have been reported following uterine artery embolization.

Thrombosis

Very Rare
Uterine artery embolization requires a brief period of immobility immediately following the procedure, and limited mobility for about a week while recovering. This can put some patients at increased risk of deep vein thrombosis and pulmonary embolism.

Thigh Paresthesia

Very Rare
Paresthesia is the sensation of numbness or tingling that you would associate with your leg ‘falling asleep’ or the feeling of ‘pins and needles.’ This has been reported after uterine artery embolization in a small handful of patients, and is likely caused by nontarget embolization (see below).

Nontarget Embolization

Very Rare
Nontarget embolization describes the misplacement of microbeads during the embolization procedure, causing them to travel to unintended organ systems. In general, nontarget embolization can damage tissue in the uterus or in other organs, but this is quite rare especially for fully trained fibroid specialists.

Infertility and Pregnancy Complications

Very Rare

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.

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More Resources
Woman discussing surgical vs. non-surgical fibroid treatment options with Fibroid Specialist
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 and pregnancy
Uterine Artery Embolization & Pregnancy: Risks, Complications, Clinical Evidence
Some institutions still caution against uterine artery embolization if a pregnancy is in your future. Meanwhile, others insist that the procedure has extremely minimal impact on fertility or pregnancy outcomes.
Fibroid Specialist in Los Angeles
Fibroid Specialist in Los Angeles
Learn more about Los Angeles Fibroid Specialist Dr. Michael Lalezarian.
References

[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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