Uterine Fibroid Embolisation

Minimally invasive womb sparing treatment for fibroids without the need for surgery.

Uterine fibroids are a benign growth within the uterus (womb). They are common – occurring in about 25% of women. Symptoms include:

  • Heavy periods and prolonged bleeding
  • Severe period pain
  • Pressure – urinary or bowel problems

Fibroids cause heavy abnormal bleeding by distorting the lining of the womb. The heavy bleeding caused by fibroids can lead to tiredness, fatigue and low energy due to iron deficiency anaemia.

Pressure (or bulk) symptoms are caused by fibroids pressing on adjacent organs, typically the bladder. When very large they can also cause bloating.

Do I need treatment?

Only patients who are symptomatic need treatment. Approximately 60% of women with fibroids will not be symptomatic. Many women will have one or more small (1-2 cm) fibroids which do not cause any problems. If you are concerned by any of the following then you may wish to consider treatment:

  • Heavy bleeding with frequent changes of pads
  • Having to wear double pads
  • Passing large clots
  • Tiredness due to anaemia
  • Concerns over periods limit your work, social life or normal activities
  • Having to pass urine frequently
  • Incontinence when laughing or sneezing

What causes fibroids?

We don’t know for sure. We do know they are more common in women over 40 and those with a family history. The risk may also be increased by diet, obesity and blood pressure.

Are fibroids cancer?

No. Fibroids are non-cancerous, benign tumours, known medically as leiomyomas. They do not spread to other parts of the body in the way cancers do. It possible however for a fibroid to develop into a malignant growth (a leiomyosarcoma). Sometimes this can be picked up on MRI scan performed prior to fibroid embolisation. Additionally, if a patient does not respond as expected to fibroid embolisation this may alert us to the possibility of an underlying cancerous component.

How is disease managed?

Fibroids can be managed in the following ways:

  • Medically – for example using contraceptive medication to control bleeding symptoms. This does not treat the fibroids themselves
  • Surgically – either by myomectomy or hysterectomy. Myomectomy involves surgical removal of individual fibroids. Hysterectomy, removal of the entire uterus is a definitive treatment for symptoms from fibroids but comes with the risks of anaesthesia and surgery. These risks may be reduced by modern surgical approaches.
  • Fibroid Embolisation (UFE) – this minimally invasive approach uses tiny particles to block the blood supply to the fibroids, causing them to reduce in size.

The first line treatment option is medical management. Should this fail then consideration is given to the number, location and size of fibroids as well as your symptoms, age and menopausal status in deciding with you what is the most appropriate treatment.

Undoubtedly symptoms are best managed by an individual patient-centred approach and some women would be best served by surgery and others by UFE. When you are seen in rooms by the IR specialist you can trust that you will be offered treatment only if it is thought to be the best option for you as an individual.