How Uterine Fibroid Embolization Works for Large Fibroids

Uterine fibroids are non-cancerous growths in the uterus that affect millions of women worldwide. While many fibroids are small and asymptomatic, larger fibroids can cause significant discomfort and disrupt daily life. Symptoms like heavy menstrual bleeding, pelvic pain, frequent urination, and even infertility can greatly impact quality of life. For women seeking an effective, minimally invasive treatment, uterine fibroid embolization (UFE) has emerged as a great solution. This article provides an in-depth explanation of how UFE works to treat large fibroids, offering a pathway to relief and restored well-being.

UFE is a minimally invasive procedure designed to shrink uterine fibroids by cutting off their blood supply. Fibroids thrive on nutrients and oxygen delivered through blood vessels. By blocking these vessels, UFE essentially starves the fibroids, causing them to shrink over time. This approach eliminates the need for major surgery, such as a hysterectomy, allowing women to preserve their uterus and recover more quickly.

The procedure is typically performed by an interventional radiologist—a specialist trained in using imaging techniques to guide tiny instruments through blood vessels. This expertise ensures precision and minimizes damage to surrounding tissues.

The Role of Imaging in UFE

Before UFE, diagnostic imaging plays a critical role in evaluating the size, location, and number of fibroids. Magnetic resonance imaging (MRI) a detailed view of the uterus, allowing the physician to plan the procedure effectively. MRI provides precise size, number and location of the fibroids. Large fibroids, due to their size and vascular nature, require careful assessment to ensure the procedure’s success and safety.

Large fibroids: Is UFE an option?

Single fibroids larger than 5 cm are considered large. When UFE (uterine fibroid embolization) was initially introduced 25 years ago, very large fibroids—those greater than 10 cm in diameter—were considered a relative contraindication. However, several clinical studies since then have demonstrated that UFE is safe and effective for treating large fibroids (References 1–4).

In our experience, large fibroids can be safely treated with UFE, achieving excellent results comparable to those for smaller fibroids. With UFE, there are no size or quantity restrictions; it can treat fibroids of any size and number.

In contrast, fibroids larger than 10 cm are not typically removed using laparoscopic (keyhole) surgery and usually require conventional open surgery. Treating large fibroids is an area of expertise at the Florida Interventional Institute. Dr. Mohan has conducted research in this field and has demonstrated favorable results (References 5–6).

Benefits of UFE for Large Fibroids

Large fibroids often cause more pronounced bulk symptoms due to their size, making effective treatment essential. UFE offers several advantages for women with large fibroids:

• Uterus Preservation: Unlike a hysterectomy, UFE allows women to retain their uterus, which is particularly important for those planning to conceive or who wish to avoid major surgery.
• Minimal Downtime: The minimally invasive nature of UFE leads to shorter recovery periods and less disruption to daily life.
• Effectiveness: Studies show that UFE can effectively reduce the size of large fibroids and improve symptoms in most patients.
• Lower Risk of Complications: Compared to open surgery, UFE carries a lower risk of infection, blood loss, and other complications.

Step-by-Step: How UFE is Performed

1. Preparation and Anesthesia
   UFE begins with administering local anesthesia at the entry point, usually the upper thigh or wrist. This ensures minimal discomfort during the procedure. Patients remain awake but are sedated for relaxation.
2. Accessing the Arteries
   A tiny catheter is inserted into the femoral artery in the groin or the radial artery in the wrist. Using real-time X-ray imaging (fluoroscopy), the catheter is guided to the uterine arteries that supply blood to the fibroids.
3. Embolizing the Fibroids
   Once the catheter is in position, the interventional radiologist injects embolic agents, small particles made of medical-grade material, into the artery. These particles block the blood flow to the fibroids, causing them to lose their nutrient supply. The healthy uterine tissue remains unaffected as it receives blood from other vessels.
4. Final Steps and Recovery
   After ensuring all fibroid-feeding vessels are embolized, the catheter is removed, and a small bandage is applied to the entry site. The entire procedure typically lasts about one to two hours.

What to Expect During Recovery

Recovery from UFE is generally quicker than surgical alternatives. Patients may experience cramping, fatigue, or mild nausea in the first few days, which can be managed with prescribed medications. Most women return to their regular activities within one to two weeks.

Over the following months, the fibroids gradually shrink, and symptoms improve. Research shows that up to 90% of women experience significant relief from heavy bleeding, pain, and pressure after UFE.

Uterine fibroid embolization has revolutionized the treatment of large fibroids, offering a safe and effective alternative to invasive surgery. By targeting the fibroids’ blood supply, this minimally invasive procedure provides significant symptom relief and improved quality of life. Women who struggle with the burdens of large fibroids can find hope and healing through this advanced treatment.

If you’re exploring treatment options for uterine fibroids, reach out to the Florida Interventional Institute. Our team of experts is dedicated to providing comprehensive care tailored to your needs. Take the first step toward a healthier, more comfortable life by contacting us today.

References:

1. https://pubmed.ncbi.nlm.nih.gov/20066419/
2. https://pubmed.ncbi.nlm.nih.gov/25571883/
3. https://pubmed.ncbi.nlm.nih.gov/20442999/
4. https://pubmed.ncbi.nlm.nih.gov/14573425/
5. https://www.eventscribe.net/2023/ISET-Posters/fsPopup.asp?PosterID=546772&mode=posterinfo
6. https://www.eventscribe.net/2023/ISET-Posters/fsPopup.asp?PosterID=546774&mode=posterinfo