These are two names for the same procedures. UAE can apply to any procedure for uterine artery embolization, such as emergency post-partum or post-operative bleeding. UFE applies specifically to fibroid treatment, therefore, we use UFE throughout our site.

An interventional radiologist uses radiologic imaging to guide catheters throughout the body to treat conditions that previously required surgery. They are both certified by the American Board of Radiology and have earned an additional Certificate of Added Qualification (CAQ) in vascular and interventional radiology. Most IRs who perform UFE are CAQ certified.

Unless they have interventional training, it’s not likely. However, gynecologists are critical to evaluating pelvic masses, abnormal uterine bleeding, and managing surgical complications. UFE shouldn’t be performed without gynecologist support.

No, it’s been used for 20 years to treat emergency, life-threatening bleeding. All devices and medications used are within FDA-labeling guidelines. UFE is widely available in the United States and Europe, and it’s being taught in interventional radiology fellowship training programs across the country. More than 100,000 UFE procedures have been performed worldwide, including roughly 22,000 annually in the United States.
Although this was once considered the case, recent research shows rapid fibroid growth indicates uterine cancer in only 0.23% of cases. In one study, among 371 women out of 1,300 who were thought to have uterine cancer due to “rapidly growing fibroids,” only 0.27% were identified as having malignancy.

Leiomyosarcoma (which sounds similar to leiomyomata, the word for fibroids) is a tumor that isn’t associated with the degeneration of a pre-existing benign fibroid. Leiomyosarcoma typically appears in post-menopausal women in the 50s or 60s. They’re usually found with a pelvic mass, abnormal bleeding, and pelvic pain, and it occurs in less than 1% of women. There’s no reliable screening test for this malignancy. UFE isn’t typically offered to post-menopausal women.

Because UFE is a uterine-sparing procedure, it’s critical to rule out cervical, endometrial, and ovarian cancer prior to the procedure. A Pap smear can screen for cervical cancer. An endometrial biopsy can detect endometrial cancer and other non-fibroid causes of abnormal uterine bleeding. Ultrasound and MRI can evaluate ovarian cancer, particularly when large fibroids obscure ovarian evaluation on physical exam.
As a synthetic hormone, Lupron induces “chemical menopause,” marked by a significant reduction in estrogen levels. It effectively shrinks fibroids and uterine size by roughly 50% by shrinking the fibroids’ blood supply. The effect is temporary, and fibroids quickly regrow when you stop taking the drug. Side effects usually limit Lupron’s use to a few months.

Because enlarged blood vessels that feed fibroids are desired during UFE for more effective tumor embolization, we recommend postponing UFE for at least 8 weeks after your last Lupron injection.

UFE treats fibroids throughout the uterus regardless of size, number, or location. Pedunculated fibroids could be the exception because they occur on a stalk and may project from the uterus’s outer layer. They do respond to UFE, but to avoid possible complications, many interventional radiologists feel there are better treatments, such as laparoscopic removal, including hysteroscopic resection.

Almost all fibroids (except those that are already degenerated and calcified) will respond to UFE. But is the shrinkage enough to reduce symptoms? Post-UFE, the average uterine volume reduction is 50%. If your uterus is very large, 50% may not be enough for symptom relief. Therefore, a hysterectomy may provide better treatment.

A uterus between 22-24 weeks gestational size seems to be the upper limit of obtaining a good UFE outcome. However, each case must be evaluated individually.

Except for some cramping during the first 6-10 hours as your fibroids break down, UFE doesn’t cause any pain. The amount of cramping you’ll experience is difficult to predict, but many women describe it like moderate-severe menstrual cramps. The PCA pump helps you control the pain immediately after the procedure, and oral medications can provide relief when you’re discharged.

Spinal and epidural anesthesia can be used for post-UFE discomfort. But they aren’t necessary in most cases, and they introduce more risk and expense.

These polyvinyl alcohol (PVA) particles have been used for more than 20 years in embolization procedures without any adverse or allergic reactions. We have used Biosphere Medical Embosphere particles exclusively since April 2001 with excellent results.

The particles are too big to move through the uterine or fibroid capillaries, so as blood flow slows down, they are incorporated into the blood clot. They don’t dissolve, aren’t absorbed, and can’t migrate throughout your body.

Once the fibroid dies, the tissue softens and is reabsorbed by the body as it shrinks. It’s eventually replaced by scar tissue that isn’t sensitive to hormonal changes during the menstrual cycle. Typically, fibroids and the overall uterus shrink by 50%.

Based on worldwide UFE results, we know the uterus tolerates UFE very well. Some normal uterine tissue is embolized, but the uterus recruits blood supply from the cervix, vagina, and ovaries. Less than 1% of collateral circulation cases aren’t sufficient. In those instances, you could feel lingering pain, potentially resulting in a hysterectomy.

You can experience cramps and fatigue for the first few days post-procedure. During this time, your fibroids are breaking down. Most people can resume normal activities within 7-10 days. In rare instances, symptoms can linger for 2-3 weeks after UFE.

Wait until after your checkup (around 7-10 days) to have sex. Also, if you typically use tampons for menstrual bleeding, use another form of protection for your first post-UFE cycle.
Most patients report either no change or an uptick in their sexual desire. Women who previously experienced fibroid-induced pain during sex usually see improvement. Sexual release changes for some women, as well. After UFE, some can experience internal orgasm – intense, pleasurable uterine contractions that are distinctly different from clitoral orgasm.

Conversely, a few women note a decrease in response. The exact reason is unknown, but injury to cervical nerves may be responsible. Interventional radiologists must be careful to avoid the cervico-vaginal branch of the uterine artery during UFE. Discuss any concerns about sexuality during your initial consultation.

UFE treats every fibroid—regardless of size, number, or location—present at the time of the procedure. Dead fibroids don’t regrow. New fibroids have recurred in a few women who responded successfully to UFE.

Once a woman reaches menopause, fibroids usually don’t grow anymore. For women in their 40s, the time from procedure to menopause may be short. But younger women face a higher likelihood of new fibroid development.

If you live in or near Hampton Roads, Va., we’re happy to evaluate you and perform your UFE. If you’re traveling from out-of-state, you will receive concierge services. If you’re unable to travel, the Society of Interventional Radiologists can help you identify a provider in your area.