Uterine artery embolisation

Uterine artery embolisation is used to treat fibroids. Fibroids are growths of muscle and fibrous tissue that can develop in the womb. They are not normally harmful but can sometimes cause problems like heavy periods, abdominal or back pain, and pain during sex.

What are the symptoms of fibroids?

Many women with fibroids don’t have any symptoms and may not be aware that they have them. In many cases, fibroids are picked up during a routine scan or abdominal examination.

For around one in three women, fibroids cause symptoms such as:

• Heavy periods
• Painful periods
• Abdominal pain
• Constipation
• Needing to urinate (pee) more often
• Pain or discomfort during sex

If your fibroids are causing symptoms that impact your quality of life, you may be a candidate for uterine artery embolisation.

At your first consultation, you will be seen by a consultant gynaecologist, a doctor specialising in conditions affecting the female reproductive system. Your consultant will ask you about your symptoms as well as your general health, menstrual cycle, and whether or not you plan to get pregnant in the future. They may order scans like an MRI, or ultrasound, or arrange for you to have another procedure such as hysteroscopy, laparoscopy, or biopsy to confirm your diagnosis.

At Circle Health Group, your first appointment is very important as it's where we get to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. It is important to us that you are as well-informed and comfortable as possible before, during, and after your treatment, so please feel free to ask your consultant any questions and discuss any concerns you may have.

At the end of your appointment, your consultant will decide whether uterine artery embolisation is a suitable treatment for you. They will explain the procedure fully including the risks and benefits, what happens during the procedure and what to expect during your recovery.

Uterine artery embolisation has many benefits including:

• The procedure can be performed under local anaesthetic, eliminating the risks associated with having a general anaesthetic
• Faster recovery time when compared to surgical treatments for fibroids such as hysterectomy (removal of the womb) or myomectomy (surgical removal of fibroids)
• No large incisions or stitches
• Reduced risk of complications such as bleeding or infection
• Avoidance of side effects associated with hormonal treatments for fibroids
• Pain relief:78 to 94% of women report significant or total relief of pain after uterine artery embolisation
• The womb remains intact and normal hormone cycles continue

Your consultant will tell you everything you need to do to prepare for your surgery. If there's anything you're not sure about, or if you have any questions about your procedure, speak to your consultant or call the hospital for advice.

Before your surgery, tell your consultant about any medical conditions or allergies you have and any medication you are taking, including over-the-counter medicines. Your consultant may tell you to stop taking some medications like blood thinners or non-steroidal anti-inflammatory drugs (NSAIDs) before your operation. This is to reduce the risk of bleeding during and after your surgery.

You will not be able to eat or drink anything from midnight on the day of your operation.

What lifestyle changes can I make before my surgery?

Being in the best possible health before your surgery can reduce the risk of complications and speed up your recovery. To make sure you are as healthy as possible before your surgery:

• Eat a healthy, balanced diet with plenty of fruit, vegetables, lean proteins, and whole grains
• If you smoke, try to stop at least eight weeks before your surgery
• Avoid alcohol for a few days before and after your surgery. Alcohol thins the blood and can increase the risk of bleeding
• Take regular exercise

Uterine artery embolisation is performed under local anaesthetic which means you'll be awake for the procedure but won't feel any pain. You may be offered a sedative to help you relax during the procedure.

During the procedure, your consultant will make a small incision (cut) in your groin. A small thin tube called a catheter is inserted through the incision into your femoral artery (the main artery in your thigh). Using contrast dye and X-rays, the catheter is guided towards your womb.

Once the catheter is in your uterus, your consultant will inject a substance containing tiny particles that block the blood supply to the fibroids. Your consultant will use X-rays to check that the blood supply to the fibroids has been successfully blocked off.

When the procedure is finished, theatre staff will apply pressure to the incision to stop the bleeding. This normally takes around fifteen to twenty minutes.

Uterine artery embolisation normally takes between 30 minutes and one hour.

Recovery from any type of procedure is different for everyone and depends on factors such as your age, general health and whether there were any complications during your procedure. Your consultant will be able to give you an estimated recovery timeline based on your individual circumstances.

After your uterine artery embolisation, you will be taken to the recovery room where you will be monitored closely until you are ready to return to your room. You may need to lie flat for a while after your surgery.

You will likely experience some cramping pain after your surgery, especially in the first twenty-four hours. Your healthcare team will give you regular pain relief to manage this, but please let a member of your team know if you experience any pain or discomfort after your procedure.

It's normal to lose a watery or mucous-like fluid from your vagina for several weeks after your procedure. You may also pass fibroid tissue through your vagina.

You may not have a period for several months after your uterine artery embolisation and your period may be lighter than usual for a few months after that. Around 1% to 5% of women stop having periods permanently after uterine artery embolisation.

Looking after yourself after surgery

• Follow your consultant's instructions carefully and call the hospital if you have any questions or concerns
• Keep your incision site clean and dry. You may have surgical strips over your incision site. These can be removed after a few days
• You will probably experience cramps similar to period pain for a few days after your procedure. Take regular painkillers as prescribed
• Get up and walk around frequently, but avoid strenuous activities until your consultant tells you it's safe
• Eat a fibre-rich diet and drink plenty of water to avoid constipation. Straining during bowel movements may cause complications. Ask your consultant to prescribe a mild laxative if necessary
• Do not douche, use tampons or have sex until your consultant tells you it's safe to do so

How many nights will I need to stay in the hospital?

Most people spend two nights in hospital after uterine artery embolisation. Talk to your consultant about how long you can expect to stay in hospital after your procedure.

Will I be able to drive home?

You will not be able to drive yourself home from the hospital after your uterine artery embolisation. Please make arrangements for someone to come and collect you.

How soon can I go back to work?

How soon you can go back to work after your uterine artery embolisation varies according to your individual recovery and the type of job you do. We recommend that you allow at least two weeks off work after your procedure. You may feel quite tired for several days and it's common to feel period-like pain for a while after your operation.

How soon can I drive?

You should not drive until you can safely control your vehicle and perform an emergency stop comfortably. This is normally between one and two weeks after your procedure. Driving before you are ready could be dangerous and may invalidate your insurance. Make sure you get the all-clear from your consultant and your insurance company before driving after uterine artery embolisation.

When will I be back to normal?

Uterine artery embolisation is a minimally-invasive procedure and most people are fully recovered and able to resume normal activities between a week and two weeks after the procedure. Most women see an improvement in their symptoms within two to three weeks and have complete relief after around six months.

Although it is a minimally-invasive procedure, as with any surgery, uterine artery embolisation carries a small risk of complications. Your consultant will explain all the possible risks and complications before your procedure and answer any questions you may have. Being as well-informed as possible will help put your mind at rest and allow you to make an informed decision so please ask any questions you may have.

Possible complications of uterine artery embolisation include:

• Infection
• Injury to the surrounding tissues
• Allergic reaction to the contrast dyes or sedative medication
• Damage to the blood vessels
• The surgery may be unsuccessful in relieving symptoms
• Infertility

We answer some of your most commonly asked questions about uterine artery embolisation.

Does uterine artery embolisation cause infertility?

Infertility is a known complication of uterine artery embolisation, but there is currently insufficient data on how many women become infertile or experience pregnancy complications as a result of the procedure. If you plan to have children in the future, discuss this with your consultant before making a decision about uterine artery embolisation.

Is uterine artery embolisation safe?

Uterine artery embolisation is a generally safe procedure when compared to alternative treatments for fibroids. As with any medical procedure, there is a small risk of complications. Your consultant will explain all the possible risks and complications to you before your procedure enabling you to make an informed decision.

Can you take a bath straight after uterine artery embolisation?

No. Your consultant will advise you about when you can take a bath or shower after your uterine artery embolisation. In general, you can shower twenty-four hours after your procedure, but should not take a bath for at least seven days after your surgery.

Does uterine artery embolisation cause menopause?

A rare complication of uterine artery embolisation is early menopause. This may occur if the blood supply to the ovaries is inadvertently cut off during the procedure. If you are worried about uterine artery embolisation triggering early menopause, discuss this with your consultant before your procedure.

At Circle Health Group we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about uterine artery embolisation, book your appointment online today or call a member of our team directly.

Content reviewed by Circle in-house team March 2023. Next review due March 2026.

1. Uterine Artery Embolization, John Hopkins
2. Uterine Artery Embolization, Medline Plus
3. Pregnancy success and outcomes after uterine fibroid embolization: updated review of published literature, PubMed