Fibroids Treatment Without Hysterectomy: What Uterine Fibroid Embolization Offers

Fibroids (myomas or leiomyomas) are non-cancerous growths of the muscle of the uterus. They are common, and many women with fibroids have no symptoms at all. Depending on their size, number, and location, however, they can cause:

• Heavy or prolonged menstrual bleeding
• Anemia and tiredness
• Pelvic pressure or a feeling of fullness
• Frequent urination or difficulty emptying the bladder
• Back or leg pain
• Pain during intercourse
• A visibly enlarged abdomen

Fibroids need a good blood supply to grow. That fact is the basis of embolization.

Treatment depends on your symptoms, the type of fibroids, your age, and whether you plan a pregnancy. Options include medication to control bleeding or temporarily shrink fibroids, hormonal devices, myomectomy (surgical removal of the fibroids while keeping the uterus), hysterectomy (removal of the uterus), and uterine fibroid embolization.

Hysterectomy is a definitive solution and the right choice for some women. Others want to keep their uterus, avoid major surgery, or shorten their recovery. For them, UFE is worth discussing, ideally together with their gynecologist.

UFE is performed by an interventional radiologist. Through a small puncture in the groin or wrist, a thin catheter, about as fine as a strand of spaghetti, is guided under X-ray imaging into the uterine arteries.

Tiny particles are injected to block the small vessels that feed the fibroids. Deprived of their blood supply, the fibroids shrink over the following weeks and months, and symptoms such as bleeding and pressure typically ease. The normal uterine tissue has a richer network of blood supply and recovers. There is no abdominal incision.

For a step-by-step explanation, see our guide, Uterine Fibroid Embolization (UFE).

The Cochrane Collaboration, which produces systematic reviews of clinical trials, reviewed five randomized trials comparing UFE with surgery (hysterectomy or myomectomy). Their 2012 review found:

• No significant difference in patient satisfaction between UFE and surgery at two years or at five years.
• No significant difference in the rate of major complications.
• UFE significantly reduced the length of the procedure, the hospital stay, and the time to return to routine activities, and lowered the likelihood of needing a blood transfusion.
• UFE was associated with more minor complications, more unscheduled readmissions, and a higher chance of needing further surgery within two to five years.
• There was very low-quality evidence suggesting that myomectomy may lead to better fertility outcomes than UFE.

In other words, UFE offers a faster recovery and similar satisfaction, with a trade-off: a higher chance that some women will need another procedure later. Women who plan a future pregnancy should discuss this carefully before choosing.

In Dr. Adam Farkas’s clinical experience, success rates for catheter-based treatments range from 70% to 90%, depending on the individual case. This is not a guarantee.

UFE is usually considered for women with symptomatic fibroids who want to avoid hysterectomy or major surgery, who prefer a shorter recovery, or for whom surgery carries higher risk. Suitability is determined after imaging, usually ultrasound and often MRI, which shows the size, number and position of the fibroids. Some fibroid types and locations respond better than others.

More information is available on our Uterine Fibroids page and on the UFE treatment page.

UFE is performed under local anesthesia at the catheter entry site with sedation. General anesthesia is not needed. In Dr. Farkas’s practice, it is a day procedure, so most women do not need to stay overnight.

Discomfort during the procedure itself is minimal. Cramping pelvic pain in the hours and days after UFE is common as the fibroids react to the reduced blood flow, and the team provides pain relief and clear instructions in advance. Most women return to routine activities gradually.

Many women notice lighter periods after UFE, which is often the main goal. The Cochrane review found no significant difference in long-term ovarian failure rates between UFE and surgery. Regarding pregnancy, the evidence is limited, and the review noted very low-quality evidence favoring myomectomy for fertility. If you hope to become pregnant, raise this at your consultation so the plan fits your goals.

Bring any recent imaging, especially pelvic ultrasound or MRI reports and, if possible, the images themselves. Bring blood test results, particularly hemoglobin and iron levels, and a list of your medications, including hormonal treatments and blood thinners. It also helps to note how many days your period lasts, how often you change protection on the heaviest days, and what symptoms affect you most. Finally, think about your priorities: keeping your uterus, avoiding surgery, recovery time, and any plans for pregnancy. These shape which option fits you best.

It may be. Suitability depends less on the number of fibroids and more on their type, size and position. Imaging helps the team assess whether embolization is likely to help in your situation.

If fibroids are controlling your calendar and you want to explore treatment that keeps your uterus, a consultation can help you compare the options. Dr. Adam Farkas, an interventional radiologist, sees patients at a clinic in Modi’in. Book a consultation.

This article provides general information and does not replace personal medical advice. Treatment decisions are made only after evaluation by a physician.