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Uterine Artery Embolization

Non-Surgical Treatment For Uterine Fibroids

Procedure Summary: A small tube called a catheter is guided through the blood vessels to reach the uterine arteries. Micro-sized beads are injected through the catheter into the fibroid, blocking the fibroid’s blood supply and causing it to shrink.
Uterine artery embolization diagram: non-surgical treatment for uterine fibroids

Uterine artery embolization (UAE) is used to treat fibroids. It is a minimally-invasive procedure offered at ProFibroidMD to relieve heavy bleeding, pain, and other symptoms in patients with uterine fibroids. This procedure has many unique advantages over conventional surgery:

  • Effective – 85% of women report that they are satisfied with the procedure or experience sustained symptom relief
  • Clinically Proven – UAE is supported by multiple clinical studies and nearly two decades of practice
  • Pregnancy & Fertility – pregnancy is possible after UAE
  • Fast Recovery – hospital stay not required, most women return to their normal activities within 1 week

In this article, our Fibroid Specialists go in-depth on uterine artery embolization. You’ll learn:

Uterine artery embolization specialist Dr. Lalezarian provides fibroid symptom relief in Los Angeles, California

Fibroid Symptom Relief
in Los Angeles

ProFibroidMD is a leading provider of uterine artery embolization (UAE), the least invasive treatment option for uterine fibroid symptom relief. Our Fibroid Specialist, Dr. Michael Lalezarian has helped countless women overcome their fibroids and get back to their happy, healthy selves.
5-star fibroid symptom relief
“He is truly dedicated, and an extraordinary physician who’s really concerned with his patients!”

Adrianne S, October 2018

What is Uterine Artery Embolization?

Uterine artery embolization is used to treat fibroids. Fibroids receive the majority of their blood supply directly from the uterine arteries. This blood supply is required for fibroids to grow and maintain their size. Uterine artery embolization, also called uterine fibroid embolization (UFE), is a minimally invasive procedure in which tiny particles are injected into the uterine artery to cut off blood supply to the fibroids. After embolization, the fibroids shrink and symptoms are relieved.

How Does Uterine Artery Embolization Compare to Other Treatment Options?

Compared to surgical options like hysterectomy and myomectomy, uterine artery embolization offers the fastest recovery time, the shortest hospital stay, and the lowest risk of procedural complications. It is clinically proven to be just as effective as surgical options when it comes to symptom relief and patient satisfaction. Uterine artery embolization has the added advantage of keeping the uterus healthy and intact, so pregnancy after uterine artery embolization is still possible.

Visuals of how uterine artery embolization works
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Uterine Artery Embolization Procedure: What to Expect

Fibroid Screening

Your visit to ProFibroidMD will begin with a review of your medical history, followed by a physical exam. Usually uterine fibroids can be diagnosed with a simple ultrasound exam of the lower abdomen.

Evaluation for Uterine Artery Embolization

An MRI scan may be used to rule out other conditions and confirm that any anomalies observed during your ultrasound are indeed fibroids. Your Fibroid Specialist may also use an MRI or other imaging techniques to get a good look at your vascular anatomy and prepare for your uterine artery embolization procedure.

On the Day of Your Procedure

After checking in with the receptionist, the staff at ProFibroidMD will provide you with a disposable gown and will be able to answer any questions you may have. You will have an IV placed in your arm for fluids and medications. You will be moved to a bed surrounded by large imaging equipment that allows your Fibroid Specialist to take live X-ray images of your major blood vessels during the procedure. Unless you request it, you will not require general anesthesia and will not be “put to sleep.” You will be provided with conscious sedation to relax you and minimize any pain during the procedure.

There are no major incisions required for the uterine artery embolization procedure, but a tiny puncture will be made in the forearm or the upper leg. Your Fibroid Specialist will then proceed to navigate a small tube through this puncture to the blood vessels that supply your uterine fibroids and deliver therapy. The procedure usually takes less than an hour. Although you will be awake throughout the procedure, a specialized nurse will be monitoring you to keep you comfortable.

Uterine Artery Embolization Recovery

After your uterine artery embolization procedure, you will be taken to a recovery room for around 6 hours for monitoring. Throughout your recovery, ProFibroidMD staff will ensure that your puncture site is properly closed and any post-op pain is under control. How long you stay in monitoring is usually at the discretion of your physician, and an overnight hospital stay may be recommended if you are experiencing more severe post-op pain.

Uterine Artery Embolization Pain

Pain is normal following uterine artery embolization, and is typically present for 3 to 4 days. Over-the-counter medications can help with this pain and are usually sufficient, but additional pain control may be prescribed. In most cases, a full recovery is made 1 to 2 weeks following the procedure, after which you can gradually return to normal activities like work and exercise. The normal course of recovery usually includes some vaginal bleeding, which should become lighter in the months following uterine artery embolization as the fibroids continue to shrink.
Woman getting ultrasound screening for uterine artery embolization
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Uterine Artery Embolization FAQs

Does uterine artery embolization work?

The main goal of fibroid treatment is to alleviate fibroid symptoms like heavy bleeding and pelvic pain. Several clinical studies have established that uterine artery embolization is as effective at alleviating fibroid symptoms as hysterectomy or myomectomy surgery.

In these studies, treatment success is measured by asking women whether or not they are satisfied with treatment or by asking them about their experiences with fibroid symptoms. Two years after uterine artery embolization, around 85% of women report that they are satisfied with the procedure or remain free of fibroid symptoms. A similar percentage of women report that they are still happy with their results 5 years after treatment.

How long does uterine artery embolization last?

For the majority of cases (around 65%), uterine artery embolization lasts indefinitely. However, clinical studies have shown that some women require an additional procedure (reintervention) following uterine artery embolization. Reintervention is often caused by the development of entirely new fibroids, or regrowth of existing fibroids that were only partially occluded during the first procedure. According to the highest quality clinical data, about 20% of women elect for reintervention within 2 years of their first procedure, increasing to 25-30% at 5 years.

How common are uterine artery embolization complications?

Uterine artery embolization complications are uncommon during the procedure. The highest quality clinical studies have demonstrated that complications occur at a rate of 0% to 9%, and most complications can be managed during the procedure without long-term health consequences.

What are the side effects of uterine artery embolization?

Uterine artery embolization side effects tend to resolve on their own within the first 30 days following the procedure. The most common side effects include: post-embolization syndrome (pain, nausea, mild fever, flu-like symptoms), hot flashes, vaginal discharge, fibroid expulsion, and hematoma formation (bruising). Less common side effects include UTI, urinary retention, urinary incontinence, thrombosis, thigh paresthesia, infection, and temporary amenorrhea (absence of menstruation).

Where do they cut for uterine artery embolization?

There are no major incisions involved in the uterine artery embolization procedure. Only one tiny puncture is made in the upper thigh or in the forearm. This tiny puncture allows the Vascular Specialist to access your fibroids through your arteries and deliver therapy.

How long is uterine artery embolization recovery?

Women undergoing uterine artery embolization should plan for 1 to 2 weeks of recovery before returning to normal activities like work and exercise. Multiple studies have looked at how long it takes for women to make a full recovery after uterine artery embolization. In most studies, uterine artery embolization recovery time averages between 9 and 12 days, but exact recovery time will vary from person to person.

Why is uterine artery embolization painful afterwards?

Uterine artery embolization works by inducing ischemia (blockage of blood flow) to the fibroids and depriving the fibroids of blood, oxygen, and nutrients. Although ischemia is the goal of the UAE procedure, ischemia may also activate pain signals that respond to oxygen deficiency. This is thought to cause cramping pain around the site of treatment 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.

What happens to fibroids after uterine artery embolization?

After uterine artery embolization, the blood vessels feeding the fibroids are blocked, causing the fibroids to receive an insufficient blood supply. This leads to an ischemic reaction in the fibroids (injury from lack of oxygen), which causes them to undergo necrosis (death of cells) and shrink.

How much do fibroids shrink after uterine artery embolization?

Fibroids shrink by 40% to 75% in the first 6 months after uterine artery embolization, and continue to shrink over time. This causes the uterus to shrink by 26% to 59%, which is why uterine artery embolization is effective in alleviating fibroid symptoms.

How long does it take for fibroids to shrink after uterine artery embolization?

Fibroids begin to shrink immediately after the uterine artery embolization procedure, and continue to shrink throughout the next year. Many women note improvement in their bleeding symptoms immediately following the procedure, but it can take up to 3 months for fibroids to shrink enough for women to notice major symptom improvements. In one study of uterine artery embolization, 200 women were asked about their symptoms 3 months after treatment. 87% of the women described improvement in their bleeding symptoms, and 93% described improvement in pelvic pain and pelvic pressure symptoms.

Can you become pregnant after uterine artery embolization?

Yes, you can become pregnant after uterine artery embolization. The uterus stays healthy and intact, which is why many women choose uterine artery embolization.
Woman consulting with nurse after uterine artery embolization
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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 UAE/UFE, the least invasive treatment for uterine fibroids.

Fibroid symptoms: what's normal, what's not
Fibroid Symptoms: What’s Normal, What’s Not?
Uterine fibroids can cause heavy bleeding, pelvic pain, weight gain, and pregnancy challenges. Our Fibroid Specialists go in-depth on the common and the not-so-common symptoms of uterine fibroids.
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).
[2] Younas K, Hadoura E, Majoko F, Bunkheila A. A review of evidence-based management of uterine fibroids. The Obstetrician & Gynaecologist 2016;18:33–42.
[3] Bulman, J.C., Ascher, S.M., Spies, J.B. (2012). Current Concepts in Uterine Fibroid Embolization. RadioGraphics, 32(6), 1735-1750.
[4] Khan, A. T., Shehmar, M., Gupta, J. K., & Gupta, J. (2014). Uterine fibroids: current perspectives. International Journal of Women’s Health, 6, 95–114.
[5] Spies, J. B. (2013). Current evidence on uterine embolization for fibroids. Seminars in Interventional Radiology, 30(4), 340–346

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