What exactly is a uterine fibroid?
A fibroid—also called a leiomyoma or myoma—is a benign tumor arising from smooth muscle and connective tissue of the uterus. Fibroids are not the same as uterine cancer. They may occur as a single growth or as many separate tumors and can range from a few millimeters to masses large enough to substantially enlarge the uterus.
Where a fibroid grows is often as important as how large it is.
Intramural
Grow within the muscular uterine wall and can contribute to heavy bleeding, pressure, or both.
Submucosal
Project toward or into the uterine cavity. Even relatively small lesions can cause substantial bleeding and may affect fertility.
Subserosal
Grow outward from the uterus and more often cause pressure, abdominal fullness, urinary frequency, or constipation.
Pedunculated
Grow on a stalk either toward the cavity or outward from the uterus; their anatomy can influence treatment choice.
Why do fibroids cause symptoms?
Symptoms depend on location, size, number, vascularity, and relationship to the uterine cavity and nearby organs. A small cavity-distorting fibroid may cause severe bleeding, while a much larger outward-growing fibroid may primarily cause pressure. Many fibroids cause no symptoms and need no treatment.
What symptoms can fibroids cause?
Bleeding symptoms
- Heavy or prolonged menstrual bleeding
- Bleeding between periods
- Iron-deficiency anemia
- Fatigue related to blood loss
Bulk symptoms
- Pelvic pressure or fullness
- Abdominal enlargement
- Urinary frequency
- Constipation
- Back or pelvic pain
How fibroids are evaluated
Pelvic ultrasound is often the first imaging study. MRI can be particularly useful when symptoms are complex, the uterus is enlarged, adenomyosis is suspected, the number and location of fibroids need precise definition, or embolization is being planned. Imaging also helps identify findings that may suggest another diagnosis.
Imaging and treatment planning
Ultrasound often confirms the presence of fibroids, while MRI can provide a more complete map of the uterus. MRI can show the location and vascularity of dominant fibroids, identify coexisting adenomyosis, and help determine whether the symptoms and anatomy are well suited to embolization.
What is UFE?
Uterine fibroid embolization—also called uterine artery embolization—is a catheter-based procedure performed by an interventional radiologist. Through a small arterial access site, a catheter is guided into the uterine arteries. Microscopic embolic particles are delivered into the vessels feeding the fibroids, reducing their blood supply. Fibroids subsequently soften and shrink, while the uterus is preserved.
What happens after the blood supply is blocked?
UFE does not physically remove fibroids. It shuts down the small arterial branches that sustain them. The fibroids undergo ischemic degeneration, soften, and gradually shrink over the following months. Bleeding often improves before maximal shrinkage occurs. The goal is symptom relief—not necessarily making every fibroid disappear on imaging.
Who may consider UFE?
UFE may be considered for patients with symptomatic fibroids who want a uterine-sparing, minimally invasive alternative to surgery. The decision should incorporate fibroid anatomy, severity of bleeding or bulk symptoms, age, prior treatment, future pregnancy goals, coexisting adenomyosis, and the relative benefits of myomectomy, hysterectomy, medications, and other options.
Alternatives to UFE
Alternatives include observation, medications, hysteroscopic resection for selected intracavitary fibroids, myomectomy, selected ablative therapies, and hysterectomy. The best choice depends on anatomy, symptoms, age, reproductive plans, prior treatment, and personal preferences.
What is the procedure and recovery like?
UFE is typically performed with image guidance and sedation through radial or femoral arterial access. After treatment, cramping and pelvic discomfort from post-embolization inflammation are expected and are managed with a structured pain-control regimen. Most patients return gradually to normal activities over the following days to roughly a week, although recovery varies.
Benefits, limitations, and risks
UFE avoids a surgical incision and generally has a shorter recovery than major surgery. Potential risks include access-site complications, infection, transient or persistent amenorrhea, fibroid passage, need for additional treatment, and rare injury to nontarget tissue. Fertility and pregnancy after UFE require individualized counseling because pregnancy is possible after UFE, but reproductive planning may influence whether UFE or myomectomy is preferred.
Procedure Video
See how uterine fibroid embolization works
Educational UFE overview and procedural explanation. Third-party educational video; technique and equipment vary.