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Risks
By Mayo Clinic staffMajor complications occur rarely in women undergoing uterine artery embolization. These may include:
- Infection. A degenerating fibroid can provide a site for bacterial growth and lead to infection of the uterus (endomyometritis). Many uterine infections can be treated with antibiotics, but in extreme cases, infection may require a hysterectomy. Serious infections appear to be more likely when the fibroid is located on the inside of the uterus (submucosal fibroid).
- Damage to other organs. Unintended embolization of another organ or tissue could lead to serious illness. Even when embolization is performed correctly, damage to the ovaries can occur. This could result in your periods stopping — rare if you're age 40 or younger but more common if you're age 50 or older when you have the procedure done.
- Radiation exposure. Uterine artery embolization exposes your ovaries to radiation for imaging, about the same amount as two barium enemas performed to examine your colon.
- Scar tissue. Uterine artery embolization for fibroids that project toward the outside of your uterus may result in the formation of adhesions, bands of scar tissue between pelvic organs. But surgical treatment of fibroids, such as myomectomy, also carries this risk.
- Possible problems in future pregnancies. Women can and do have healthy pregnancies following uterine artery embolization. However, some evidence suggests pregnancy complications, including abnormalities of the placenta attaching to the uterus, may be increased following the procedure.
Medical opinion is mixed about whether uterine artery embolization is a good treatment choice for large fibroids projecting into the uterine cavity or outside the uterus or for pedunculated fibroids, which hang from a stalk. A specific concern is that a pedunculated fibroid hanging from the uterine cavity could detach from your uterus after uterine artery embolization. A detached fibroid retained in the uterus could lead to infection.
Reasons to avoid this procedure
Don't undergo uterine artery embolization if you have:
- A history of pelvic radiation
- A history of kidney failure
- Possible pelvic cancer
- An active, recent or chronic pelvic infection
- Poorly controlled diabetes
- Inflammation of the blood vessels (vasculitis)
- A bleeding disorder
- A severe allergy to contrast material containing iodine
- A desire to optimize chances for pregnancy
Discuss uterine artery embolization with your obstetrician-gynecologist, primary care doctor or an interventional radiologist.
References
- The American College of Obstetrics and Gynecologists. Alternatives to hysterectomy in the management of leiomyomas. Obstetrics & Gynecology. 2008;112:387.
- Haney AF. Leiomyomata. In: Gibb RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:916.
- Kim D, et al. Uterine leiomyoma (fibroid) embolization. http://www.uptodate.com/home/index.html. Accessed Feb. 16, 2011.
- Kim MD, et al. Long-term results of symptomatic fibroids treated with uterine artery embolization: In conjunction with MR evaluation. European Journal of Radiology. 2010;73:339.
- Marshburn PB, et al. Uterine artery embolization as a treatment option for uterine myomas. Obstetrics and Gynecology Clinics of North America. 2006;33:125.
- Walker WJ, et al. Long-term follow up of uterine artery embolization - an effective alternative in the treatment of fibroids. BJOG. 2006;113:464.
- Narayan A, et al. Uterine artery embolization versus abdominal myomectomy: A long-term clinical outcome comparison. Journal of Vascular and Interventional Radiology. 2010;21:1011.
- The Practice Committee of the American Society for Reproductive Medicine. Myomas and reproductive function. Fertility and Sterility. 2008;90(suppl):S125.
- Van der Kooij SM, et al. Uterine artery embolization vs. hysterectomy in the treatment of symptomatic uterine fibroids: 5-year outcome from the randomized EMMY trial. American Journal of Obstetrics and Gynecology. 2010;203:105.e1.
- Pron G, et al. Pregnancy after uterine artery embolization for leiomyomata: The Ontario multicenter trial. Obstetrics & Gynecology. 2005;105:67.
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