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Why it's done
By Mayo Clinic staffYou might choose uterine artery embolization if you are premenopausal and:
- You have severe pain or heavy bleeding from uterine fibroids
- Surgery is too risky for you or you want to retain your uterus
- Optimizing a future pregnancy is not your chief concern
Uterine fibroids can cause severe symptoms in some women, including heavy bleeding, pelvic pain and an enlarged abdomen. Uterine artery embolization destroys fibroid tissue and eases these symptoms — especially heavy bleeding and abdominal swelling — and provides an alternative to surgery to remove fibroids (myomectomy) or surgery to remove your uterus (hysterectomy). The procedure causes fibroids to shrink and soften, but it doesn't make them disappear.
Uterine artery embolization takes advantage of physiological changes caused by uterine fibroids. A uterus with fibroids has more small blood vessels than does a normal uterus because fibroids stimulate formation of new blood vessels to the tumors. During uterine artery embolization, small particles (embolic agents) follow this increased blood flow to the fibroids and lodge in branches that feed the growths. Doctors believe that most normal uterine tissue isn't harmed, in part because it gets blood from additional arteries, which are referred to as collateral circulation.
- 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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