Published: May 24, 2011
Updated: May 24, 2011
Uterine fibroid embolization (UFE) is a minimally invasive alternative to surgery for patients with symptomatic uterine fibroids.
Fibroids are benign tumors of the uterus, and are a common cause of heavy or prolonged bleeding, pelvic pain and pressure in women.
Examples of fibroids
Interventional Radiology at Duke University Medical Center has been performing UFE since 1999. Having treated more than 500 women with fibroid related symptoms, we are devoted to providing safe, effective, and individualized care.
Our three goals are to educate women on the treatment options available, perform a safe and effective UFE when indicated, and provide excellent care for women following their procedure.
In August 2009, the American Journal of Obstetrics & Gynecology stated, “UFE is a safe, effective, and durable nonsurgical alternative to hysterectomy” (PDF, 335 KB).
The procedure involves injecting particles into the arteries that supply the uterus. The particles block the blood flow to the fibroids, which results in their destruction and shrinkage.
This procedure is performed under sedation and requires overnight observation.
Menstrual-like cramps are typical the first few days following UFE, so women are sent home with pain medication to maintain comfort. Most women return to normal activity within a week.
It is necessary to have a recent pelvic examination and a normal PAP smear by a gynecologist or primary care provider.
For women with abnormal uterine bleeding or a thickened endometrial stripe on imaging, an endometrial biopsy should be done to rule out endometrial carcinoma or hyperplasia.
MRI image
An magnetic resonance imaging (MRI) of the pelvis is obtained prior to visiting the interventional radiology (IR) physician. The MRI helps to determine whether or not a person is a candidate for UFE.
During the visit with the IR physician, a thorough history and physical will be completed, the MRI imaging will be reviewed, and the procedural details will be discussed.
On the day of the procedure, an IV will be placed to administer sedation and any other medications.
Once in the procedure room, an interventional radiology technologist will scrub and drape the right groin area. Sedation will be given.
UFE procedure
The physician will inject lidocaine to numb the skin in the groin area. The physician will then place a catheter into the femoral artery. This catheter will be directed into the arteries that supply blood to the uterus and ultimately the fibroids.
Injection of a uterine artery with a fibroid
(Click image to enlarge.)
Injection following UFE
(Click image to enlarge.)
When a safe catheter position is established, particles are injected to stop the flow of blood to the fibroids. Once both uterine arteries are treated, the catheter is removed. This procedure usually takes less than two hours to perform.
After the procedure is over, it is necessary to spend time in the recovery room before going to a private room for overnight observation.
You may contact the offices of Michael J. Miller MD, David Sopko, MD, and Waleska M. Pabon-Ramos, MD, MPH, Division of Vascular-Interventional Radiology, at Duke University Medical Center at 919-684-7280 or e-mail Debbie Semmel, FNP-BC, at deborah.semmel@duke.edu to make an appointment.
