What is uterine fibroid embolization (ufe)?

Uterine Fibroid Embolization (UFE)
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Uterine fibroid embolization: Overview

Uterine fibroid embolization is a treatment to destroy or shrink fibroids. Fibroids are growths on or in your uterus. Sometimes they're called fibroid tumors, but they aren't cancer.

You may be awake during the procedure. But you will get medicine to help with pain. And you may be given medicine to help you relax. First the doctor will put a thin, flexible tube into a blood vessel in the upper thigh. The tube is called a catheter. Then the doctor sends a solution through the catheter. It prevents your fibroids from getting blood. Without blood, the fibroids shrink or die.

The treatment usually takes 1 to 3 hours. After the procedure, you may stay in the hospital overnight or go home the same day.

You may have some pain for a few hours to a few days. But sometimes pain can last for a couple of weeks. It may take about 1 to 2 weeks to fully recover.

This treatment should reduce pain and bleeding from fibroids.

Uterine fibroid embolization

Uterine fibroids are noncancerous growths in the uterus that can cause pain and bleeding. Uterine fibroid embolization (UFE) is a procedure that shrinks or destroys uterine fibroids by blocking the artery that supplies blood to them.

During a UFE procedure, a doctor places a thin, flexible tube called a catheter into the upper thigh and guides it into the uterine arteries that supply blood to the fibroid(s). A solution is then injected into the uterine artery through the catheter. It blocks blood flow to the fibroid and shrinks or destroys the fibroid.

How can you care for yourself after uterine fibroid embolization?

Activity

  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Try to walk each day. Start out by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
  • For 1 week, avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
  • Avoid strenuous activities, such as biking, jogging, weightlifting, and aerobic exercise, until your doctor says it's okay.
  • You may shower. Do not take a bath for a few days or until your doctor tells you it is okay.
  • You may have some vaginal bleeding. Wear sanitary pads if needed.
  • Ask your doctor when you can drive again.
  • You will probably need to take 1 week off work. It depends on the type of work you do and how you feel.
  • Ask your doctor when it is okay for you to have sex or use tampons. Do not douche.

Diet

  • You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • Drink plenty of fluids (unless your doctor tells you not to).
  • You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Be safe with medicines. Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor tells you not to).
    • Ask your doctor for a different pain medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Other instructions

  • Wear loose, comfortable clothing and avoid anything that puts pressure on your belly for a few days.
  • You may want to use a heating pad on your belly to help with pain.

How well does uterine fibroid embolization (UFE) work?

UFE is an effective treatment. It reduces the size of fibroids. And, in most cases, it improves symptoms. But fibroids can come back. Some people need more treatment several years after they have UFE.

What can you expect as you recover from uterine fibroid embolization?

When the procedure is over, you will likely have several hours of bed rest. You may stay in the hospital overnight for more observation and pain control. Or you might go home the same day.

You may have pain for a few hours to a few days after the procedure. But sometimes pain can last for a couple of weeks. Your doctor may prescribe pain medicine. Or your doctor may talk to you about trying an over-the-counter pain medicine, such as ibuprofen (Advil, Motrin). You may also have mild nausea for several days.

You may have some vaginal bleeding or discharge for several weeks to months after the treatment. Some people also pass a fibroid from the vagina after several months. This can happen even a year later. If you do pass fibroid tissue, see your doctor right away to be sure that you don't get an infection.

It may take about 1 to 2 weeks to fully recover and return to your regular activities. You will likely have a follow-up appointment several weeks after your procedure.

After uterine fibroid embolization: Overview

Uterine fibroid embolization is a procedure done to destroy or shrink uterine fibroids. Your doctor put a thin, flexible tube (catheter) into a blood vessel in your upper thigh. Then the doctor sent a solution through the catheter to prevent your fibroids from getting blood.

You can expect to feel better each day. But you may get tired quickly. You may need about 1 to 2 weeks to fully recover.

You may have pain or cramps for several days after uterine fibroid embolization. But sometimes pain can last for a couple of weeks. You may also have mild nausea for several days. Some people have vaginal bleeding or grayish or brownish vaginal discharge for several weeks to months. These are all common side effects of the treatment.

Your next few menstrual cycles may be heavier than normal. Some people pass fibroid tissue for several months after the procedure.

Make sure to avoid heavy lifting for about a week.

How is uterine fibroid embolization (UFE) used to treat fibroids?

Uterine fibroid embolization (UFE) shrinks or destroys uterine fibroids by blocking the artery that supplies blood to them.

During UFE, a doctor places a thin, flexible tube called a catheter into the upper thigh. It is guided into the uterine artery that supplies blood to the fibroids. A liquid is then injected into the uterine artery through the catheter.

UFE may be an option when:

  • You don't want to get pregnant in the future. It's possible to get pregnant after UFE. But there may be risks.
  • You still have heavy uterine bleeding or anemia after several months of treatment.
  • You have fibroid pain or pelvic pressure that affects your quality of life.
  • You have urinary or bowel problems because of a fibroid.
  • You don't want to have a hysterectomy or myomectomy.
  • You have a disease or disorder that makes surgery with general anesthesia dangerous.

What happens on the day of your uterine fibroid embolization?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be canceled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
  • Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • You will be kept comfortable and safe by your anesthesia provider. You may get medicine that relaxes you or puts you in a light sleep. The area being worked on will be numb.
  • The procedure will take about 1 to 3 hours.

How is uterine fibroid embolization done?

You may be awake during the procedure. But you will get medicine to help with pain. And you may be given a sedative to help you relax.

First, a thin, flexible tube called a catheter is placed into a blood vessel in the upper thigh (femoral artery). A substance called contrast material is then injected into the catheter. You may feel some warmth as it travels up to the uterus. The doctor uses real-time X-ray on a video screen (fluoroscopy) to see the arteries and then guides the catheter to the arteries that supply blood to the fibroid. A solution is injected into those uterine arteries through the catheter. It builds up in the targeted arteries and blocks blood flow to the fibroid.

Deciding about uterine fibroid embolization: Overview

Uterine fibroid embolization (UFE) is a procedure done by a doctor. It blocks blood flow to fibroids in the uterus. (It is also called uterine artery embolization.) UFE is a possible option in place of surgery for fibroids.

UFE may not be recommended if you want to get pregnant. It's possible to get pregnant after having UFE, but it may increase your risk for fertility or pregnancy problems.

UFE may be a good treatment option if you don't want to receive blood transfusions (which can be needed after myomectomy) or have other health conditions that make general anesthesia dangerous. UFE is not safe if you're allergic to contrast material (used for fluoroscopy during UFE).

UFE has several advantages over hysterectomy, myomectomy, and treatment with GnRH-a (the hormone-suppressor medicine used to shrink fibroids).

  • General anesthesia and an abdominal (belly) incision are not required.
  • There is a lower chance of needing a blood transfusion.
  • Multiple fibroids may be treated at the same time.
  • It does not cause bone-thinning (low bone density) or the other serious side effects associated with GnRH-a therapy.

Disadvantages of UFE include:

  • Possible problems with fertility. It may not be recommended if you want to get pregnant in the future.
  • Risk for infection. This can be life-threatening if not treated.
  • Fibroids can come back. Some people need more treatment several years after they have UFE.

How long does uterine fibroid embolization take?

Uterine fibroid embolization usually takes 1 to 3 hours. The timing depends on how long it takes to position the catheter and how easy it is to position the catheter in the arteries in the uterus.

How do you prepare for a uterine fibroid embolization procedure?

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what procedure is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

What are the risks of uterine fibroid embolization?

Some risks of uterine fibroid embolization include:

  • Post-embolization syndrome. This is a set of symptoms that can last for a couple of weeks after the procedure. It can include pain, fever, or nausea.
  • Problems with the ovaries or early menopause. And it may increase the risk for certain pregnancy problems.
  • Infection.
  • Unplanned hysterectomy. In rare cases, a hysterectomy is needed to treat an infected or damaged uterus.
  • Pulmonary embolism.

After uterine fibroid embolization: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have chest pain, are short of breath, or cough up blood.

Call your doctor now or seek immediate medical care if:

  • You have bright red vaginal bleeding that soaks one or more pads in an hour, or you have large clots.
  • You are sick to your stomach or cannot drink fluids.
  • You have vaginal discharge that has increased in amount or smells bad.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • A fever.
  • You have signs of a blood clot in your leg (called a deep vein thrombosis), such as:
    • Pain in your calf, back of the knee, thigh, or groin.
    • Redness and swelling in your leg or groin.
  • You have pain that does not get better after you take pain medicine.
  • You are bleeding from the area where the catheter was put in your artery.
  • You have a fast-growing, painful lump at the catheter site.

Watch closely for any changes in your health, and be sure to contact your doctor if you have any problems.

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