Uterine Artery Embolization: A Nonsurgical Approach to treating Symptomatic Fibroids

Interventional Radiology physicians at UCSF, including Maureen Kohi, MD, a specialist in women’s health and interventions, offer two treatments for uterine fibroids, both of which are part of a class of procedures called minimally invasive image-guided procedures (MIIPs.) These minimally invasive procedures may help women avoid invasive surgeries, such as hysterectomy or myomectomy.

Uterine fibroids (also called leiomyomas) are the most common benign tumors of the female pelvis. The lifetime prevalence of fibroids is greater than 80 percent among African American women and approximately 70 percent among Caucasian women. About half the women with fibroids experience symptoms which may include heavy menstrual bleeding, pelvic bulk symptoms with bladder and bowel dysfunction, abdominal bloating, pain with intercourse, and infertility. These symptoms can significantly diminish one’s quality of life.

High-intensity focused ultrasound (abbreviated HIFU and also known as magnetic resonance-guided focused ultrasound, or MRgFUS) is an innovative technique for uterine fibroid treatment. It uses focused high energy ultrasound waves to destroy fibroids without impacting the surrounding uterus. We recently discussed the benefits of HIFU here.

The second minimally invasive procedure used at UCSF to treat symptomatic uterine fibroids is called uterine artery embolization (UAE, sometimes known as uterine fibroid embolization or UFE.) This procedure works by blocking the blood supply to fibroids, which causes the fibroid tumors to shrink and die. Like HIFU, UAE is an alternative to open surgery or laparoscopic surgery for fibroids. UAE is performed while the patient is conscious, but sedated and feeling no pain, and does not require general anesthesia.

UAE is highly effective for women with symptomatic uterine fibroids. Extensive research in this area has shown outcomes following UAE to be comparable to surgery with quicker recovery and return to work.

Fibroid embolization requires overnight hospital stay after the procedure. Patients are discharged home with anti-inflammatory and pain-killing medication to help alleviate the symptoms of cramping and pain which can set in after the procedure. Many women resume light activities in a few days and the majority of women are able to return to normal activities within seven to 10 days.

Faculty in Interventional Radiology have been performing uterine artery embolization at UCSF since 1998. For more information on uterine artery embolization and options at UCSF, please click here.

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