South Florida Fibroid Center  
 
What are the benefits vs. risks?

 
 
Benefits
Minimally invasive: Uterine fibroid embolization (UFE) is less invasive than either open surgery to remove fibroid tumors or surgically removing the uterus itself. Patients ordinarily can resume their usual activities weeks earlier than if they had a hysterectomy. Blood loss during uterine fibroid embolization is minimal, the recovery time is much shorter than for hysterectomy, and general anesthesia is not required.
Relief of symptoms: Follow-up studies have shown that approximately 85 percent of women who have their fibroids treated by uterine fibroid embolization experience either significant reduction or complete resolution of their fibroid-related symptoms. This is true for women with heavy bleeding and for those with bulk-related symptoms such as pelvic pain or pressure. Overall, fibroids will shrink to half their original size six months after uterine fibroid embolization.
Durable effect: Follow-up studies lasting several years have shown that it is rare for treated fibroids to regrow or for new fibroids to develop after uterine fibroid embolization. This is because all fibroids present in the uterus, even small early-stage masses that may be too small to see on imaging studies, are treated during the procedure. UFE is a more permanent solution than another option, hormone therapy, because when hormonal treatment is stopped the fibroid tumors usually grow back. Regrowth also has been a problem with laser treatment of uterine fibroids.
 


Risks
Catheter-related risks: Any procedure that involves placement of a catheter inside a blood vessel, including uterine fibroid embolization, carries certain risks. These risks include damage to the blood vessel, bruising or bleeding at the puncture site, and infection. When performed by an experienced interventional radiologist, the chance of any of these events occurring during uterine fibroid embolization is less than 1 percent.
Allergy to x-ray contrast material: An occasional patient may have an allergic reaction to the x-ray contrast material used during uterine fibroid embolization. These episodes range from mild itching to severe reactions that can affect a woman's breathing or blood pressure. Women undergoing uterine fibroid embolization are carefully monitored by a physician and a nurse during the procedure, so that any allergic reactions can be detected immediately and reversed.
Passage of fibroid tissue: From 2 percent to 3 percent of women may pass small pieces of fibroid tissue after uterine fibroid embolization. This occurs when fibroid tissue located near the lining of the uterus dies and partially detaches. Women with this problem may require a procedure called D & C (dilatation and curettage) to be certain that all the material is removed so that bleeding and infection will not develop.
Early onset menopause: In the majority of women undergoing uterine fibroid embolization, normal menstrual cycles resume after the procedure. However, in approximately 1 percent to 5 percent of women, menopause occurs shortly after uterine fibroid embolization. This appears to occur more commonly in women who are older than 45 years when they have the procedure.
Need for hysterectomy: Although the goal of uterine fibroid embolization is to cure fibroid-related symptoms without surgery, some women may eventually need to have a hysterectomy because of infection or persistent symptoms. The likelihood of requiring hysterectomy after uterine fibroid embolization is low—less than 1 percent.
 

Other UFE Facts
An estimated 13,000-14,000 UFE procedures are performed annually in the U.S. (as of 2004).
The embolic particles are approved by the FDA specifically for UFE, based on comparative trials showing similar efficacy with less serious complications compared to hysterectomy and myomectomy (the surgical removal of fibroids).
Embolization of the uterine arteries is not new. While embolization to treat uterine fibroids has been performed since 1995, it has been used successfully by interventional radiologists for more than 20 years to treat heavy bleeding after childbirth.
Embolization of fibroids was first used as an adjunct to help decrease blood loss during myomectomy. To the surprise of the initial users of this method, many patients had spontaneous resolution of their symptoms after only the embolization and no longer needed the surgery.
UFE is covered by most major insurance companies and is widely available across the country.
Most women with symptomatic fibroids are candidates for UFE and should obtain a consult with an interventional radiologist to determine whether UFE is a treatment option for them. An ultrasound or MRI diagnostic test will help the interventional radiologist to determine if the woman is a candidate for this treatment.
Many women wonder about the safety of leaving particles in the body. The embolic particles most commonly used in UFE have been available with FDA approval for use in people for more than 20 years. During that time, they have been used in thousands of patients without long-term complications.