Uterine artery embolization (UAE), also known as uterine fibroid embolization, is an innovative, minimally invasive procedure used to treat uterine fibroids — noncancerous growths in the uterus that can cause symptoms such as heavy menstrual bleeding, pelvic pain, and pressure on the bladder or bowel. Over the past few decades, uterine artery embolization has gained recognition as an effective alternative to traditional surgical treatments like hysterectomy or myomectomy, offering women a faster recovery time and preservation of the uterus.

Uterine artery embolization is a radiological procedure designed to reduce or eliminate fibroids by cutting off their blood supply. Fibroids rely on blood vessels to grow and survive; by blocking these vessels, the fibroids shrink over time, leading to relief from symptoms.

The procedure is performed by an interventional radiologist. Using imaging guidance, a small catheter is inserted into the femoral artery (in the groin) or radial artery (in the wrist) and threaded to the uterine arteries, which supply blood to the uterus and fibroids. Tiny particles, often made of polyvinyl alcohol or similar materials, are then injected to embolize or block these arteries selectively.

Minimally Invasive: Unlike open surgery, UAE requires only a small puncture site, which results in less pain, reduced risk of infection, and minimal scarring.

Uterus Preservation: UAE allows women to retain their uterus, making it an attractive option for those who wish to avoid hysterectomy.

Shorter Recovery Time: Most patients return home the same day or after an overnight stay, with recovery times averaging 1-2 weeks, significantly shorter than traditional surgery.

Symptom Relief: Studies indicate that 85-90% of women experience significant improvement in symptoms such as heavy bleeding and pelvic pressure within a few months after the procedure.

Cost-Effective: Compared to surgery, UAE generally results in lower hospital costs and less time off work.

UAE is primarily recommended for women with symptomatic uterine fibroids who want an alternative to surgery. It is suitable for those experiencing:

Heavy or prolonged menstrual bleeding

Pelvic pain or pressure

Frequent urination or constipation due to fibroid pressure

Anemia caused by excessive bleeding

However, UAE is not typically advised for women who are pregnant, wish to conceive soon, or have certain types of fibroids, such as very small fibroids or those located inside the uterine cavity. A thorough evaluation, including imaging studies like MRI or ultrasound, helps determine candidacy.

Before the procedure, patients undergo a consultation where their medical history, symptoms, and imaging results are reviewed. Blood tests may be performed to ensure fitness for the procedure.

On the day of UAE, the patient is typically given conscious sedation or light general anesthesia. The interventional radiologist then accesses the arterial system, navigates to the uterine arteries, and injects embolic particles to block blood flow to the fibroids.

The entire procedure usually lasts 1 to 2 hours. Following the embolization, patients are monitored for a few hours for any immediate complications or pain. Mild to moderate pelvic pain or cramping is common in the first 24-48 hours and is managed with pain medication.

Most patients can resume normal activities within one to two weeks. Full symptom relief may take several weeks to months as the fibroids shrink. Follow-up imaging may be performed to monitor fibroid size and treatment effectiveness.

Potential side effects are generally mild but can include:

Post-embolization syndrome: flu-like symptoms such as fever, nausea, and fatigue lasting a few days

Spotting or irregular bleeding for several menstrual cycles

Rarely, infection or premature ovarian failure

Unlike hysterectomy, which removes the entire uterus, UAE is uterus-sparing, preserving fertility potential, although pregnancy after UAE may require close monitoring due to risks such as miscarriage or preterm labor.

Compared to myomectomy, which surgically removes fibroids, UAE is less invasive, has a shorter recovery, and avoids abdominal incisions. However, myomectomy may be preferred in women with a strong desire for future pregnancy or when fibroids are in specific locations.

Uterine artery embolization offers an effective, minimally invasive option for women suffering from symptomatic uterine fibroids. With its benefits of uterus preservation, quicker recovery, and high rates of symptom relief, UAE has become a valuable tool in fibroid management. Women experiencing fibroid-related symptoms should consult with their gynecologist and interventional radiologist to explore whether uterine artery embolization is the right treatment choice for them.