Uterine Fibroid Embolization (UFE): Non-Surgical Treatment

Heavy bleeding every month, changing protection every hour and feeling drained and anemic? Pressure and fullness in the lower abdomen, frequent urination, pelvic pain, and days when it is hard to leave the house? If you have been diagnosed with uterine fibroids, you may already have been offered surgery, sometimes even a hysterectomy. There is also a way to treat fibroids without surgery and without a hysterectomy.

Uterine Fibroid Embolization (UFE) is a minimally invasive, catheter-based treatment that shrinks fibroids while preserving the uterus. Dr. Adam Farkas, an interventional radiologist, performs the procedure and follows each patient from consultation through recovery.

Uterine fibroids (myomas) are common benign growths of the uterine muscle. Some women have no symptoms at all; others experience heavy menstrual bleeding, pelvic pain, pressure in the lower abdomen and a real impact on quality of life. Symptoms depend on the number, size and location of the fibroids. Learn more on our uterine fibroids page.

Common symptoms

• Heavy or prolonged periods, sometimes with clots
• Anemia, fatigue and weakness from blood loss
• Pressure or fullness in the lower abdomen
• Pelvic or lower back pain
• Frequent urination or pressure on the bowel
• An enlarged abdomen
• Reduced quality of life because of the fibroids

Fibroids depend on a rich blood supply to grow. During UFE, the arteries feeding the fibroids are blocked in a controlled way. Deprived of blood, the fibroids gradually shrink and soften, and symptoms such as heavy bleeding and pelvic pressure improve. The healthy uterine tissue continues to receive blood from other sources, so the uterus is preserved. A single procedure treats all the fibroids in the uterus at once, regardless of their number.

UFE is a good option for women with symptomatic fibroids who want to avoid surgery and keep their uterus, including:

• Women with heavy bleeding, pain or pressure caused by fibroids
• Women who were advised to have a hysterectomy or myomectomy and are looking for an alternative
• Women with multiple fibroids, where surgical removal is more complex
• Women who prefer to avoid general anesthesia or a long recovery

It is less suitable, or requires special consideration, when:

• You are currently pregnant
• Malignancy is suspected or the diagnosis is uncertain
• There is an active pelvic infection
• You are planning a future pregnancy. Myomectomy is usually the preferred procedure in this case, although pregnancies after embolization have been reported. This deserves a thorough discussion at the consultation
• Certain fibroid types, such as a pedunculated fibroid on a stalk, need individual assessment

Women considering embolization have a pelvic MRI beforehand to map the anatomy and the blood supply of the fibroids.

1. Get in touch. Leave your details or call, and our office will get back to you to schedule an appointment.
2. Consultation in Modiin. Consultations take place at the Elite Medical clinic in Modiin on Mondays. Dr. Farkas reviews your symptoms, imaging and records with you, explains all the options including surgical ones, and checks whether UFE suits you. Please bring a referral letter, imaging discs (ultrasound, MRI), blood tests and medical records. A video or phone consultation can also be arranged.
3. Completing the work-up. Pelvic MRI, blood tests and gynecological evaluation as needed.
4. Scheduling and preparation. The procedure is performed in the angiography suite at Shaare Zedek Medical Center in Jerusalem. You will receive detailed instructions on fasting, medications and tests.

UFE is performed by an interventional radiologist in an angiography suite under advanced imaging, with local anesthesia and sedation. General anesthesia is not required.

• A small puncture is made in an artery at the wrist or groin.
• A thin catheter is guided to the uterine arteries that feed the fibroids.
• Tiny embolic particles are injected to block the blood supply to the fibroids.
• The catheter is removed and a small dressing is applied. There are no incisions and no stitches.

The procedure usually takes about an hour and is done as a day procedure or short stay.

Does it hurt? Discomfort during the procedure itself is minimal and is reduced with local anesthesia and sedation. Afterwards, as the fibroids lose their blood supply, many women experience cramping and pain. This is expected and is treated with pain medication, first intravenously and then by mouth for several days up to a week.

Please arrange for someone to accompany you and drive you home on the day of the procedure.

• In the first days you may have pain, cramping, fatigue, mild nausea and a low-grade fever, which gradually improve with medication and rest.
• Recovery usually takes about one to two weeks.
• The fibroids shrink gradually over the following weeks and months, and bleeding and pressure improve with them.
• A follow-up visit is scheduled, with repeat imaging if needed.

A Cochrane systematic review comparing randomized trials of uterine artery embolization with surgery (hysterectomy or myomectomy) found no clear difference in patient satisfaction between the two. Embolization was associated with a shorter hospital stay and a faster return to usual activities. It was also associated with a higher rate of further surgical interventions and a higher rate of minor complications within the first year [1].

A large US study published in 2025 in the Journal of Vascular and Interventional Radiology analyzed data from about 78,000 patients. Length of stay was 1 day after embolization compared with 5 days after hysterectomy. Blood transfusion was needed in 0.7% after embolization, compared with 1.8% after hysterectomy and 2.0% after myomectomy. Reintervention within five years was 15.5% after embolization and 17.0% after myomectomy, a difference that was not statistically significant [2].

In Dr. Farkas’s clinical experience, the success rate in appropriately selected patients is between 70 and 90 percent. No outcome can be guaranteed, and your personal chances are discussed at the consultation.

• Post-embolization syndrome: pain, low-grade fever, nausea and fatigue in the first days. It is common and temporary.
• Bruising or tenderness at the puncture site.
• Temporary vaginal discharge, and occasionally passage of fibroid tissue.
• Need for further treatment: some women later need another procedure, repeat embolization or surgery [1][2].
• Effect on fertility and the ovaries: UFE may affect fertility in some women. The Cochrane review rated the evidence on fertility as very low quality [1]. Women planning a pregnancy should discuss this in depth with their doctor.
• Infection or other serious complications, which are rare when the procedure is performed by a skilled and experienced specialist.

Surgery for fibroids depends on symptoms and on fibroid size and location. It may involve removing only the fibroids (myomectomy), or removing the uterus (hysterectomy).

• Anesthesia: UFE uses local anesthesia and sedation; surgery usually requires general anesthesia.
• Incisions: one small puncture, compared with abdominal or laparoscopic incisions.
• Hospital stay and recovery: shorter stay and faster return to routine after UFE [1][2]. According to Dr. Farkas, it is a treatment with fewer complications and a much shorter recovery.
• Uterus: UFE preserves it; hysterectomy removes it.
• Repeat treatment: further intervention is more likely after UFE than after hysterectomy [1][2].
• Pregnancy plans: for women planning pregnancy, myomectomy is usually preferred.

The decision is made together with your doctor, and often with your gynecologist.

• How many fibroids do I have, where are they, and how large are they?
• Is my MRI suitable for planning UFE, or is more imaging needed?
• How do UFE, myomectomy and hysterectomy compare in my specific case?
• What are my pregnancy plans, and how do they affect the choice?
• What should I expect in the first week after the procedure?
• What happens if symptoms do not improve enough or come back?

Bring a record of your periods, including how many days they last and how often you need to change protection, and recent blood counts. These details help assess how much the fibroids are affecting you and make it easier to measure improvement later.

Heavy bleeding can lead to iron deficiency and anemia, which cause fatigue, shortness of breath and difficulty concentrating. While you weigh your options, your doctor may recommend checking your blood count and iron levels and treating anemia if needed. Some women use medication to reduce bleeding in the meantime. These measures can make the waiting period easier, but they do not remove the fibroids themselves.

• Plan several days of rest at home, with help around the house if possible.
• Take pain medication as instructed and do not wait for pain to build up.
• Keep the puncture site clean and dry, and avoid heavy lifting for the first days.
• Drink plenty of fluids and return gradually to walking and normal activity.
• Contact the team if you develop a high fever, severe pain that does not improve, foul-smelling discharge, or swelling or bleeding at the puncture site.

Fibroid care is a team effort. Before embolization, your gynecologist should complete a full gynecological assessment, including routine tests and, if needed, evaluation of the uterine lining, to confirm that your symptoms are caused by the fibroids. Dr. Farkas works together with your gynecologist and coordinates the plan. If you do not yet have a treating gynecologist, this will be discussed at the consultation.

Adenomyosis, in which tissue similar to the uterine lining grows into the uterine muscle, can cause similar symptoms and may also be treated by embolization. See adenomyosis treatment without hysterectomy.

Dr. Adam Farkas is Director of the Vascular Interventional Radiology Unit and Vascular Anomalies Clinic at Shaare Zedek Medical Center, Jerusalem, and Chair of the Israel Society of Interventional Radiology. He has performed thousands of catheter-based procedures.

Where is the consultation and where is the procedure done?

Consultations take place at Elite Medical in Modiin on Mondays. The procedure is performed in the angiography suite at Shaare Zedek Medical Center in Jerusalem.

1. Gupta JK, Sinha A, Lumsden MA, Hickey M. Uterine artery embolization for symptomatic uterine fibroids. Cochrane Database of Systematic Reviews. 2014, Issue 12, CD005073. cochrane.org/evidence/CD005073
2. Hysterectomy and Myomectomy versus Uterine Artery Embolization for Symptomatic Fibroids and Adenomyosis: National and Regional Trends and Adverse Events in 70,000 Patients. Journal of Vascular and Interventional Radiology. 2025;36(6). doi:10.1016/j.jvir.2025.02.026