Q&A: Dr. Gustainyte Explains Uterine Fibroid Embolization (UFE) Procedure in Patients with Uterine Fibroids
Uterine fibroids are benign growths formed in the uterus that can sometimes cause abnormal menstrual bleeding, pelvic pain/pressure, subfertility, and/or overall reduced quality of life in females. These non-cancerous lesions, also known as myomas, develop in the muscular wall of the uterus. Uterine fibroids are very common, affecting about 80% of women.
Symptoms related to uterine fibroids should first be managed medically, however, if this fails, then surgery or a minimally invasive procedure called uterine fibroid embolization (UFE)/uterine artery embolization (UAE) could be considered. We sat down with Dr. Vaiva Gustainyte, an interventional radiologist in Moffitt’s Department of Diagnostic Imaging and Interventional Radiology to learn more about this procedure.
What is uterine fibroid embolization and how is the procedure performed?
Uterine fibroid embolization (UFE) is a minimally invasive treatment performed by inserting a thin catheter through a femoral artery located in the patient's groin area and then guiding the catheter into the uterine arteries (typically 2) supplying the fibroids. Because fibroids typically get a lot of blood supply, they can be treated by “shutting the blood supply off”. This is done during the embolization procedure when tiny plastic particles are introduced into those vessels. Without their blood supply, fibroids shrink and, in effect, symptoms related to them gradually improve over time. The procedure is one to two hours long, is very well tolerated with “twilight” sedation, and does not require the use of anesthesia.
What is the recovery time?
UFE procedure can be performed on an outpatient basis, with one overnight stay for observation of post-embolization symptoms. Women can expect to have cramping pain post-procedure for about one to two weeks, which can be managed with NSAIDs. Normal activity can be resumed by the next day, otherwise.
How does a patient benefit from receiving a uterine fibroid embolization procedure (UFE) vs. other treatment methods?
When compared to a total hysterectomy, UFE allows women to preserve fertility and have quicker recovery time with less risk of complications. When compared to myomectomy (surgical resection of individual fibroids), UFE allows for a quicker recovery time and less risk of complications. UFE treats all fibroids during the same procedure.
The most recent major journal article in New England Journal of Medicine in 2020 states that when women were asked to rate their quality of life 0-100 (100 being best) at two years post-myomectomy vs UFE, they rated it very similarly at 84 and 80, respectively. This same article also discussed that surgery had higher complication rates (29%) vs UFE group (24%).
This article can be found here: www.nejm.org/doi/full/10.1056/NEJMoa1914735
How should a patient prepare to receive a UFE?
Women should have a discussion with their gynecologist in regard to all options available for their fibroid treatment. Workup should include evaluation of possible pregnancy, active infections, or malignancy in which case UFE would not be performed. If during interventional radiology consultation, the patient and physician decide that the procedure would be best, then women would be scheduled for their UFE procedure.
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