Uterine Fibroid Embolization (UFE)

Information about UFE for women in the San Antonio, TX area.

My name is John W. Thomas, M.D. and I am part of a large group of Radiologists in San Antonio known as South Texas Radiology Group (STRG). I get a lot of phone calls about UFE, and just about every woman who contacts me has already learned much about UFE from the Internet. 

First, understand that I perform this procedure as do several of my partners, including:

We know that many women in the San Antonio area have been told, incorrectly, that UFE is unavailable in our city. While it is true that we only recently started offering UFE as a way to control fibroid symptoms (bleeding and pain) we have been performing the same procedure (embolization of the uterine arteries) for control of bleeding after vaginal delivery or cervical cancer bleeding for over a decade. All 7 of us are fellowship-trained Vascular & Interventional Radiologists. We provide services at the three major hospitals in the South Texas Medical Center: South Texas Methodist Hospital, St. Luke's Baptist Hospital, and San Antonio Community Hospital (a.k.a. Methodist Specialty & Transplant Hospital) as well as North East Methodist Hospital, and the Nix Hospital, downtown.

Please feel free to contact me by e-mail [email protected] or by phone 210.575.4343.

Fibroids are benign tumors of the uterus. Benign means they do not behave like a cancer and spread to other parts of the body. But that does not mean they do not cause symptoms! They are a common cause of pelvic pain and abnormal vaginal bleeding. They can interfere with pregnancy, making a woman infertile.

A classic treatment for fibroids is surgical removal of the uterus: hysterectomy. But an alternative treatment, developed in France, is now available in the U.S.: uterine artery embolization (UAE) also known as uterine fibroid embolization (UFE)

The procedure blocks the blood supply to the fibroids. These tumors are hypervascular meaning they use more blood than normal tissue, stealing the blood away from adjacent structures. Blocking access to the blood is like giving the fibroid a heart attack... a "tumor attack". The fibroids will shrivel into small scars that cease to give you any problems.

The Vascular & Interventional Radiologists of STRG perform this procedure. Feel free to contact us. Or allow your family physician, internist, or gynecologist to contact us to arrange for the procedure. Make sure to ask your doctor about this alternative! The word is spreading but the idea is new enough that many physicians are unfamiliar with it. Also, many doctors are reluctant to suggest a patient try a new procedure until it has been around for many years...but that is not going to help you!

Do I have to stay in the hospital?

To keep you comfortable after the procedure we will give you medicine by IV. It is necessary that you stay in the hospital while these medications are given. Usually just one night, sometimes two.

Which hospital?

We provide services at The Methodist Hospital, St. Luke's Baptist Hospital, Methodist Specialty & Transplant Hospital (a.k.a. San Antonio Community Hospital), North East Methodist Hospital, and the Nix, downtown.

What is the difference between surgery and this embolization procedure?

Your uterus will decrease in size, but it is not removed as is done with hysterectomy. UFE is performed through an incision the size of a pencil point. Through this skin nick we access the femoral artery with a small tube (catheter) that we manipulate into the arteries feeding the uterus. Then we inject a slurry of tiny particles that are carried downstream in the arteries to the uterus and fibroids. Blood flow to the fibroids is so much higher than the uterus that the vast majority of the particles are carried to the fibroids. These particles then block flow through the arteries. Once the flow is stopped, the catheter is removed and we apply pressure by hand to the puncture site. Then we cover it with a band-aid: no stitches, no staples. Example of uterine artery before and after embolization.

If my fibroids are keeping me from getting pregnant, can I have this procedure to increase my chances of pregnancy?

We are optimistic that the procedure will work for infertility. But the clinical trials to prove this have yet to be completed. As soon as the data is available we will analyze it and, if appropriate, offer UFE for infertility. For now we perform UFE for women who have symptomatic fibroids, do not want to become pregnant, and want to avoid hysterectomy.

Does it work as well as surgery?

No. The symptoms in the vast majority of women will improve or go away completely. But there is simply no way that it will substitute for surgery for everyone. On the other hand, if you are one of the rare women whose symptoms do not resolve after our procedure, you still have the option of the hysterectomy. I should add that none of our patients have gone on to hysterectomy.

Are these my only options? UFE vs. Hysterectomy?

No. Your OB/GYN may be able to surgically remove your fibroid(s) but leave the uterus intact. This procedure is called myomectomy. Also, hormonal therapy is available that may cause your fibroids to stop causing symptoms without having to have any kind of procedure or surgery. You should explore these options with your OB/GYN doctor. We can refer you to one who is familiar with all of these options, if you wish.

Does it hurt?

Expect to experience some discomfort (pelvic cramping and back pain) during the first 24 hours. But we will work with you to keep you as pain-free as possible. You will be in control of a pump that you use to self-administer pain medication as you need it. No waiting on busy nurses to bring you relief. When you are ready to switch to pills for discomfort, you are ready to go home.

What kind of follow-up will I need to endure?

A return visit to your gynecologist with-in the first two weeks, with additional follow-up as arranged between you and  him/her. A typical follow-up schedule is office visits at 1 week, 6 weeks, 6 months, and one year after UFE with annual visits thereafter. If you do not have a OB/GYN, contact us and we will put you in touch with one familiar with UFE patients. We will also schedule you for a pelvic ultrasound at three months and one year following the procedure.

For more information, please contact me by e-mail [email protected] or by phone 210.575.4343.  Or visit the Society for Cardiovascular and Interventional Radiology's www site for answers to additional frequently asked questions.