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Risks
By Mayo Clinic staffRarely, major complications occur in women undergoing uterine artery embolization. The risk of complications from uterine artery embolization is about the same as those for surgical treatment of fibroids. 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.
- Damage to other organs. Unintended embolization of another organ or tissue can occur, although it's not as high a risk as with surgery. Whether you have embolization or surgery, disruption of the ovarian blood supply is a possibility because the ovaries and uterus share some blood vessels. If you're nearing menopause (perimenopausal), such a disruption could lead to menopause — but that's rare if you're age 40 or younger.
- Possible problems in future pregnancies. Many women have or continue healthy pregnancies after having uterine artery embolization. However, some evidence suggests pregnancy complications, including abnormalities of the placenta attaching to the uterus, may be increased after the procedure. If you want to have children, talk to your doctor about the risks of surgery and how uterine artery embolization might affect your fertility and future pregnancy.
Reasons to avoid this procedure
Avoid 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)
- An untreated bleeding disorder
- A severe allergy to contrast material containing iodine
Most fibroid sizes and locations can be treated with uterine artery embolization. Rarely a woman's uterus can be so big that it's difficult to treat with any method, and hysterectomy may be required.
Discuss the benefits and risks of uterine artery embolization with your obstetrician-gynecologist or an interventional radiologist — a doctor who uses imaging techniques to guide procedures that would be impossible with conventional surgery.
References
- Frequently asked questions. Gynecologic problems FAQ074. Uterine fibroids. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq074.pdf?dmc=1&ts=20130423T1546469165. Accessed April 23, 2013.
- Bouwsma EVA, et al. Comparing focused ultrasound and uterine artery embolization for uterine fibroids — Rational and design of the fibroid interventions: Reducing symptoms today and tomorrow (FIRSTT) trial. Fertility and Sterility. 2011;96:704.
- American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins — Gynecology. ACOG Practice Bulletin No. 96. Alternatives to hysterectomy in the management of leiomyomas. American College of Obstetricians and Gynecologists. http://guideline.gov/content.aspx?id=13318. Accessed April 23, 2013.
- Laughlin SK, et al. Uterine leiomyomas: Individualizing the approach to a heterogeneous condition. Obstetrics and Gynecology. 2011;117:396.
- Van der Kooij, et al. Review of nonsurgical/minimally invasive treatments for uterine fibroids. Current Opinion in Obstetrics and Gynecology. 2012;24:1.
- Coddington CC, et al. Fertility and uterine artery embolization. Obstetrics and Gynecology. 2010;116:439.
- Martin J, et al. Complications and reinterventions in uterine artery embolization for symptomatic uterine fibroids: A literature review and meta analysis. Cardiovascular and Interventional Radiology. 2013;36:395.
- Scheurig-Muenkler C, et al. Clinical long-term outcome after uterine embolization: Sustained symptom control and improvement of quality of live. Journal of Vascular and Interventional Radiology. In press. April 4, 2013.
- Kaump GR, et al. The impact of uterine artery embolization on ovarian function. Journal of Vascular and Interventional Radiology. 2013;24:459.
- Choi, et al. Is uterine artery embolization for patients with large myomas safe and effective? A retrospective comparison study in 323 patients. Journal of Vascular and Interventional Radiology. In press. Accessed April 4, 2013.
- Kim D, et al. Uterine leiomyoma (fibroid) embolization. http://www.uptodate.com/home. Accessed May 6, 2013.
- Kim D, et al. Interventional radiology in management of gynecological disorders. http://www.uptodate.com/home. Accessed May 6, 2013.
- Parker WH. Techniques to reduce blood loss during abdominal or laparoscopic myomectomy. http://www.uptodate.com/home. Accessed April 23, 2013.
- Uterine fibroid symptoms, diagnosis and treatment. Society of Interventional Radiology. http://www.sirweb.org/patients/uterine-fibroids/. Accessed April 7, 2013.
- Gallenberg MM (expert opinion). Mayo Clinic, Rochester, Minn. May 8, 2013.
- Stewart EA (expert opinion). Mayo Clinic, Rochester, Minn. May 17, 2013.
- Vander Kooij SM, et al. Uterine artery embolization versus surgery in the treatment of symptomatic fibroids: A systematic review and metaanalysis. American Journal of Obstetrics and Gynecology. 2011;206:e1.
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