Uterine Artery Embolization

Procedure overview

What is uterine artery embolization?

Uterine artery embolization (UAE) is a procedure that offers an alternative to traditional surgical removal of uterine fibroids. The procedure may also be referred to as uterine fibroid embolization (UFE).

Uterine artery embolization shrinks fibroids by blocking off their blood supply. The blood supply is blocked by injecting very small particles into the arteries that supply the fibroids. The particles stick to the vessel wall and cause a clot to develop, blocking off the blood supply. Once the blood supply is gone, the fibroids shrink and symptoms usually decrease or disappear. The most commonly used particle agent is polyvinyl alcohol (PVA), a substance that has safely been used in medical procedures for many years.

Uterine artery embolization is a minimally-invasive (without a large abdominal incision) technique which involves identifying which arteries supply blood to the fibroids and then blocking off those arteries.

Uterine artery embolization is performed by an interventional radiologist, a physician specializing in the field of radiology that treats a wide range of internal body conditions without making a surgical incision. Various small instruments or tools, such as catheters or wires, are used, along with various x-ray and imaging techniques (e.g., computed tomography (CT scan), magnetic resonance imaging (MRI), fluoroscopy, and ultrasound). Interventional radiology offers an alternative to the surgical treatment of many conditions and can eliminate the need for hospitalization, in some cases.

What are female pelvic organs?

The organs and structures of the female pelvis are:

  • Endometrium—the lining of the uterus

  • Uterus—also called the womb, the uterus is a hollow, pear-shaped organ located in a woman's lower abdomen, between the bladder and the rectum. The uterus sheds its lining each month during menstruation, unless a fertilized egg (ovum) becomes implanted and pregnancy follows.

  • Ovaries—two female reproductive organs located in the pelvis in which egg cells (ova) develop and are stored, and where the female sex hormones estrogen and progesterone are produced

  • Cervix—the lower, narrow part of the uterus located between the bladder and the rectum, forming a canal that opens into the vagina, which leads to the outside of the body

  • Vagina—the passageway through which fluid passes out of the body during menstrual periods. Also called the "birth canal," the vagina connects the cervix and the vulva (the external genitalia)

  • Vulva—the external portion of the female genital organs

Other related procedures that may be performed to diagnose or treat problems of the uterus include cervical biopsy, colposcopy, dilation and curettage (D and C), endometrial ablation, endometrial biopsy, hysterectomy, hysteroscopy, laparoscopy, loop electrosurgical excision procedure (LEEP), and pelvic ultrasound. Please see these procedures for additional information.

Reasons for the procedure

The primary reasons for performing a uterine artery embolization include:

  • Fibroid tumors. Fibroids, also known as uterine myomas, leiomyomas, or fibromas, are firm, compact tumors that are made of smooth muscle cells and fibrous connective tissue that develop in the uterus. It is estimated that between 20 to 50 percent of women of reproductive age have fibroids, although not all are diagnosed. Some estimates state that up to 30 to 77 percent of women will develop fibroids sometime during their childbearing years, although only about one-third of these fibroids are large enough to be detected by a physician during a physical examination.

    In more than 99 percent of fibroid cases, the tumors are benign (non-cancerous). These tumors are not associated with cancer and do not increase a woman's risk for uterine cancer. They may range in size from the size of a pea to the size of a softball or small grapefruit.

  • Excessive uterine bleeding. In general, bleeding is considered excessive when a woman soaks through enough sanitary products (sanitary napkins or tampons) to require changing every two hours. In addition, bleeding is considered prolonged when a woman experiences a menstrual period that lasts longer than seven days in duration.