Uterine fibroid embolization (UFE) is a minimally invasive procedure that shrinks fibroids by blocking their blood supply. After UFE, patients commonly experience crampy pelvic pain and discomfort as the fibroids undergo infarction.
At Florida Interventional Institute (FII), Dr. Mohan has developed a comprehensive pain-management protocol based on the best available evidence, his own research, and over a decade of clinical experience.
After the procedure, patients receive a detailed medication schedule to guide them through the recovery period. Most importantly, patients have 24/7 direct access to Dr. Mohan by cell phone during the immediate post-procedure period.
Together, these measures help ensure a smooth and pain free recovery. Post-procedure pain management is an area we take great pride in, and our patients consistently praise their recovery experience, as reflected in our reviews.
Dr. Prasoon Mohan is a pioneer in uterine fibroid embolization (UFE) research and has led several influential studies that have advanced the field. Most recently, he published a groundbreaking randomized clinical trial in the premier medical journal JAMA Network Open describing a novel technique to improve pain control after UFE. Randomized clinical trials are considered the highest level of evidence in clinical research, providing the strongest evidence that a treatment is effective.
After UFE, pain or cramping occurs because the fibroid tissue loses its blood supply (ischemia) and starts to die. As the fibroids die, they trigger an inflammatory response that causes cramping and discomfort, similar to severe menstrual cramps. Importantly, this pain is actually a sign that the treatment is working.
Patients commonly experience lower abdominal cramping, back pain, and a sensation of pelvic pressure. The discomfort is typically most intense during the first 6–24 hours after the procedure and then gradually improves. It is important to note that this period of intense pain is prevented using a targeted nerve block at Florida Interventional Institute, which is described below. This timeline reflects the body’s response to fibroid infarction. By the next morning, pain usually decreases significantly, and most patients are able to resume light daily activities. Mild cramping or discomfort may persist for a few additional days.
Some patients may also experience low-grade fever, nausea, fatigue, or general malaise in the first few days after the procedure. This is known as post-embolization syndrome. It is a common and self-limited condition that usually resolves within a few days to a week.
The superior hypogastric plexus (SHP) is a network of nerves in the pelvis that carries pain signals from pelvic organs—including the uterus—to the brain. At the end of the UFE procedure, we perform a superior hypogastric plexus (nerve) block to interrupt these pain signals.
Under fluoroscopic (X-ray) guidance, a needle is carefully positioned at the nerve plexus, and a long-acting local anesthetic is injected. This blocks the transmission of pain signals from the uterus for as long as the anesthetic agent works. In practice, patients usually experience a dramatic reduction in pelvic pain within minutes, and the effect can last approximately 24–36 hours—which corresponds to the period when post-procedure pain would otherwise be most intense.
This nerve block is the single most important intervention for controlling pain after UFE. At Florida Interventional Institute, we perform this block routinely after every UFE to help ensure a much more comfortable and smooth recovery.
This regimen typically includes:
Opioid medication for breakthrough pain, if needed
Patients are also provided with anti-nausea medication, antibiotics, and a stool softener to support recovery and minimize side effects.
To make the process easy to follow, we provide a printed medication timetable outlining exactly when to take each medication after the procedure. By following this regimen, you can expect to have a smooth and well-controlled recovery.
A key part of our post procedural management is direct patient-doctor communication. Every Florida Interventional Institute patient receives a direct number to Dr. Mohan. This means if you have severe pain-not controlled by the regimen, fever, or any other serious concerns, you can reach him directly. The rationale is that early intervention and reassurance improve outcomes: patients feel supported and rare complications can be caught quickly.
Most patients are discharged about 2 hours after the procedure. Once you arrive home, you should plan to rest for the remainder of the day. By the next day, most patients are able to walk around and perform normal activities of daily living. While you should take it easy, we recommend not staying in bed all day. Light activity—such as walking around the house—is encouraged, as it helps promote circulation and recovery.
It is important to stay well hydrated after the procedure. We recommend drinking plenty of water—up to about a gallon per day during the first week, as good hydration can help support recovery.
On the day of the procedure, after you are discharged, it is best to stick to simple, easy-to-digest foods such as soups, broth, gelatin, or similar light meals. You can gradually advance your diet as you feel better. However, it is advisable to avoid fried or oily foods for the first two days.
Dr Mohan has a great bedside manner and quiet confidence about him that puts you at ease. I first met him when he performed microwave ablation on my husband’s liver as part of his cancer treatment. One year later Dr Mohan did ablation laser therapy on my varicose veins.
Dr. Mohan makes the most complicated and complex surgeries easy and fun for the patient. He is very caring and has impeccable “Bedside Manners” which is most comforting for an afraid patient. Can’t wait to visit him again. Thanks.
Dr. Mohamed Saved my life! The care leading up till I got accepted for my liver transplant was nothing but the best and most professional and at times difficult. Being the cancer had to be controlled and not spread through out it was just that… he controlled it, got rid of it, explained every procedure thoroughly.
