A UFE has several effects on the fibroids and your body, namely that your symptoms should diminish and the fibroids should shrink. Dr. Linda Hughes, M.D., explains more.

“Typically after a uterine fibroid embolization or UFE, three things will happen in terms of a woman’s fibroid uterus. Number one, by cutting off the blood flow it’s going to control the bleeding, and women that are heavy bleeders should have a more normal menstrual cycle, shouldn’t be passing clots, and if they’ve had issues with anemia or low blood counts as a result of the heavy menstrual cycle, that should correct itself.

“Secondly, by cutting off the blood flow, the fibroids that are there should shrink. The amount of shrinkage is extremely variable, and on a low end they shrink as little as 30%, on the high they can shrink as much as 90%, and different fibroids within an individual can shrink different amounts. Just as important is the shrinkage though, is the fact that the fibroids also get softer.

“Pathologists, if they look at a hysterectomy or myomectomy specimen, typically describe fibroids as being like a firm rubber ball. They’re smooth muscle because the uterus is smooth muscle. If they have a specimen after someone has had an embolization procedure, typically they tend to be very soft and mushy, and almost like a scoop of oatmeal.

“And the reason we know this is not that the majority of women after an embolization are going on to have a surgery to have them removed, but the whole way this procedure came about, is that there were certain gynecologists over the years, that used to ask the Interventional Radiologist to embolize the uterine arteries before they did a myomectomy or hysterectomy to minimize bleeding at the time of surgery.

“It was a fellow about 18 years ago in Paris that noticed in the time frame between women having the embolization procedure and then going on to have the surgery that the vast majority of these women were better clinically and didn’t need to have surgery, which is how embolization came about specifically for fibroids as a stand alone treatment.”

See Dr. Suzanne Slonim’s answer to this question.

 

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Fibroids can make sexual intercourse increasingly painful or unappealing, and most women see an improvement after UFE. Linda Hughes, M.D., explains further.

“A lot of women, when they come in for a consultation to see if they’re a candidate for the fibroid embolization procedure, are either embarrassed or bashful about discussing their sexual activity and if they have pain with sexual activity as a result of the fibroids. There are some women, depending on the size and the location of the fibroids, that intercourse can be extremely painful, as well as they can also have bleeding issues.

“So, many women with these symptoms notice that they do have a dramatic improvement after the embolization procedure. It’s extremely unusual, and I’m not aware of any patients in my practice that have had pain or worse issues with intercourse after an embolization. Typically they present with the symptoms, and they improve after the procedure.”

See Dr. Suzanne Slonim’s answer to this question.

 

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The need for a second UFE is rare, but it does happen in a few patients. Dr. Linda Hughes, M.D., explains the reasons this might happen.

“It’s extremely unusual for someone to need a second uterine fibroid embolization or UFE, but in a small amount of patients there is flow coming from other sources besides the uterine arteries. Depending on the age of the patient and their desire for future fertility or having children will determine how aggressive we are with that individual with an embolization. So, in a small percentage of patients it’s not unusual for them to have to come back for a second embolization.”

See Dr. Suzanne Slonim’s answer to this question.

 

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• Blog: Why Would Someone Need a Second UFE?
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Every insurance company is different, and you will need to find out what kind of coverage yours offers for UFE. Dr. Linda Hughes, M.D., had this to say:

“Most insurance companies will pay for the uterine fibroid embolization. It has been many years since we’ve had an issue with an insurance company challenge the actual procedure for they realized it is a short procedure compared to surgery. It is a shorter recovery time and patients are back to work sooner. So it’s in everyone’s best interest for them to authorize and pay for the procedure.”

See Dr. Suzanne Slonim’s answer to this question.

 

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• How long should I expect to stay in the hospital?
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After a UFE, you should see a decrease in the amount of bleeding you experience, but it shouldn’t go away altogether. Dr. Linda Hughes, M.D. gives all the details about what you should see after your procedure.

“Ideally after a fibroid embolization, the patients should still have their period. It should be a regular menstrual cycle and if heavy bleeding is been a part of the symptomatology, that heavy bleeding should resolve. Typically 90% of women within the first menstrual cycle will notice the difference in terms of heavy bleeding, the other 10% can take two to three cycles before they notice the difference in their symptoms. In a small percentage of patients, we had mentioned that one of the complications, can be going into menopause, and if the patient goes into menopause as a result of the embolization obviously they won’t continue to have a period.”

See Dr. Suzanne Slonim’s answer to this question.

 

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Uterine fibroid embolization is a procedure used to block the blood flow to the fibroids, causing them to shrink. Therefore, it is unlikely that the fibroids will come back. Dr. Linda Hughes, M.D., details the process.

“It is extremely unusual, if a patient has a successful fibroid embolization, for the symptoms to return. In a small amount of patients there can be some blood flow coming off of another source, such as the ovary. Often times in that situation if it’s a young woman and they haven’t had their children yet, we choose to be conservative and don’t embolize the ovarian arteries. So there are some women that will have some relief, a partial relief but will need to have a second embolization on that basis.”

See Dr. Suzanne Slonim’s answer to this question.

 

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Many women are concerned that UFE will not work because their fibroids are too large. Fibroids of any size can be treated with UFE, but it may not be the best solution for every woman. Dr. Linda Hughes, M.D., explains.

“We’re able to embolize a fibroid of any size. The question is whether or not it’s appropriate for the individual. Each patient is different and it’s important for us to review the MRI because that gives us a good idea of the size, number, location and the vascularity of the fibroids in the uterus.

“So, to answer that question we can embolize a fibroid of any size, but often times there are certain fibroids that are so large that the patient may benefit from a myomectomy or a hysterectomy in terms of the pain and the cramping and the recovery process afterwards.”

See Dr. Suzanne Slonim’s answer to this question.

 

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• If I have been diagnosed with multiple fibroids, am I still a good candidate for Uterine Fibroid Embolization (UFE)?
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Uterine fibroid embolization involves blocking the blood supply to the fibroids, no matter how many you have. Dr. Linda Hughes, M.D., gives more details.

“Many women are concerned that if they have multiple or many fibroids that they’re not a candidate for this procedure. The vast majority of women that we see and that we treat actually do have more than one fibroid. It does not matter how many fibroids, whether a patient has 1 or 101 fibroids, the way the procedure is designed by embolizing both uterine arteries, we’re knocking off and cutting off the blood supply to all of the fibroid tissue.”

 

You might also enjoy:

• Will Uterine Fibroid Embolization (UFE) be able to treat very large fibroids?
• Will my fibroids or the symptoms of my fibroids come back?
• Why Would Someone Need a Second UFE?

 

Your body may go through several changes after your uterine fibroid embolization procedure as you adjust to decreased symptoms related to fibroids. Dr. Linda Hughes details the process you will go through.

“After a uterine fibroid embolization, the blood flow is cut off to the fibroids, and several things happen. Number one, the fibroids are going to decrease in size, and typically most fibroids are in the wall of the uterus, so that they’re going to shrink, and scar and retract into the wall.

“Secondly, since you’ve cut off the blood flow, it’s going to correct the bleeding a lot of women present with heavy bleeding in passing blood clots and having issues with anemia. That should correct itself. Just as important as the shrinkage is the remaining fibroid tissue, which is also going to be a lot softer, so it’s not going to have the same pressure or mass effect on the bladder, back, or on some of the nerves in the area.

“In a small percentage of women, some of the fibroids can actually be sticking into the lining of the uterus, and in that situation, we know with the MRI and the ultrasound imaging prior to the procedure that they have a submucosal component, which is the part of the fibroid inside of the lining. We counsel women just to be aware that they might have to wear a little mini pad or a liner for the first maybe 4-6 weeks because there may be some mucus or watery discharge. This is the portion of the fibroid that is in the lining so they are not going to expel an entire fibroid, but they may have some discharge.”

See Dr. Suzanne Slonim’s answer to this question.

 

You might also enjoy:

• What to Look Out For the Week After Your UFE Procedure
• Will my fibroids or the symptoms of my fibroids come back?
• Will I still get my period after a Uterine Fibroid Embolization (UFE)?

 

Normally, your interventional radiologist and your OB/GYN will work together to coordinate your follow-up care. Dr. Linda Hughes, M.D., explains what she does as the interventional radiologist.

“Typically in terms of follow up care after a uterine fibroid embolization, patients will be seen in the office by the Interventional Radiologist, usually 7 to 10 days after the procedure. It’s an opportunity for us to be able to review the films that we’ve obtained during the procedure with the patients. It gives us an opportunity to examine the patient as well as to see how their recovery time is and a lot of women need to have paper work filled up prior to returning to their full time activities at work.

“Beyond that initial post-operative period, we usually do follow up imaging and depending on the individual, it could be at six months, it could be at 12 months and we also encourage the patient that they are to maintain their annual appointment with their gynecologist.”

See Dr. Suzanne Slonim’s answer to this question.

 

You might also enjoy:

• How long should I expect to stay in the hospital?
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