What is it?
- Performed by an interventional radiologist using x-ray guidance (fluoroscopy).
- Minimally invasive procedure with only a puncture site; no large incisions.
- Block blood flow to fibroids in the uterus to shrink and improve symptoms.
- Catheter is inserted into the uterine artery from the groin (femoral access) or arm (radial access).
- IV contrast dye is injected into the catheter to find arteries feeding the fibroids.
- Then, beads are injected to cut off the blood supply to the fibroids.
- Bead composition is leucite. Not recognized by the body.
Types of fibroids (leiomyoma)?
- Subserosal, intramural, and submucosal
What does the work-up include?
-MRI pelvis WWO IV contrast to assess the location, number, and size of fibroids as well as blood supply to fibroids.
- PAP test within 90 days
- Endometrial biopsy (most often for only women 40 years and older)
- STD cultures
- Preprocedure blood work: CBC w PLTs, BMP, PT/INR, HCG
What does the procedure involve?
- Moderate sedation and local anesthetic
- Supine (back) position
- Length of procedure: ~3 hours
- Stay overnight for observation; and control of nausea and pain. Provide PCA pump. Usually, most intense abdominal/pelvic pain occurs within the 6 to 8 hours following the procedure. Controlled well with intravenous medications.
- Get an IV antibiotic during the procedure.
- Discharge the next day with prescriptions for antiemetic, stool softener, NSAID (ibuprofen), and narcotic (Percocet) for break through pain.
How will I feel after the procedure?
May experience post-embolic syndrome which is described as having “flu-like” symptoms. Post-embolic symptoms may include decreased appetite, fatigue, low-grade fever, nausea, and pain.
What is the recovery period?
Follow pelvic rest for 1 month. Pelvic rest includes nothing in the vagina (e.g., no douching, no intercourse, no foreign objects, no tampons).
Advise to take 2 weeks off from work (depending on type of job) due to moderate fatigue.
No physical activity or heavy lifting for 48 hours after the procedure.
Pre-UFE symptoms may persist for 3 to 6 months.
UFE results should be seen within 1 to 2 cycles. Fibroids usually shrink enough for a change in symptoms within 3 months, ~50 % shrinkage in 6 months. Stop shrinking after 1 year.
What is the follow-up plan?
Follow-up with gynecologist in 4 weeks. Gynecologist will determine whether to stop pelvic rest.
What are the risks?
Force into menopause. Why? Everyone’s anatomy is different. Occasionally, beads enter an artery that supplies an ovary and may stop blood flow to the ovary.
Submucosal fibroids have increased risk for prolonged vaginal discharge.
What are the benefits?
UFE spares the ovaries and uterus. Keep your organs.
No GENA required. Lowers sedation risks.
No large abdominal incisions. Quicker recovery period.
Many fibroids may be treated at the same time.
UFE is a highly effective treatment for menorrhagia; ~ 90% patients improve
What are the disadvantages?
Expensive procedure and not all insurance companies cover the UFE procedure.
New fibroids may grow and procedure may need to be repeated several years later.