Uterine leiomyomas, more commonly called fibroids or fibroid tumors, are benign (noncancerous) masses of the uterus. They occur in 25 percent of women of childbearing age and are symptomatic in 10 to 20 percent. Uterine fibroids may cause abnormal bleeding, pelvic pain, fullness, low back pain, urinary incontinence, and constipation. They typically will regress with menopause. Hormone therapy can help, but typically must be maintained through menopause or the symptoms will recur. The most common treatment for symptomatic fibroids is to surgically remove the uterus (hysterectomy). Another surgical option is myomectomy. With myomectomy, a surgeon removes the fibroid(s) and leaves the rest of the uterus.

A relatively new option that is becoming more popular is an interventional radiology procedure called uterine artery embolization (UAE) or uterine fibroid embolization (UFE). UAE involves putting a catheter into the arteries that feed the uterus and injecting tiny particles that block the blood flow to the fibroid(s). After UAE, the fibroid(s) slowly shrink in size over several weeks. The normal portion of the uterus usually has decreased blood flow for a few days, but then survives quite well. The treatment targets the fibroids more than the normal uterus because the arteries feeding the fibroids are somewhat larger than the arteries feeding the uterus. The injected particles tend to be too large to get into the arteries that feed the normal uterus.

Patients are usually in the hospital only a day or two after UAE, compared to three or four days for surgery. Typically, patients are back to their normal activities within a week after UAE, compared to about six weeks for surgery. The complications from UAE are less severe on average than for surgery. UAE is about 85-90% effective in treating the symptoms of uterine fibroids. The procedure can be repeated if the symptoms recur.

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Fibroid tumors

Catheter in uterine artery

Embolization of fibroid

Embospheres