Uterine artery embolization: Treat fibroids without surgery

This procedure can treat uterine fibroids and reduce symptoms without surgery. Learn if it's right for you.

If you suffer from uterine fibroids, your doctor may recommend a procedure called uterine artery embolization (UAE) — also called uterine fibroid embolization. This procedure effectively treats fibroids and reduces symptoms without surgery. Learn more about this treatment and if it is right for you.

Uterine artery embolization: How it’s done

Uterine fibroids can cause severe symptoms in some women, including heavy menstrual bleeding, pelvic pain and swelling in the abdomen. Uterine artery embolization reduces these symptoms by destroying fibroids.

During the procedure, a doctor uses a slender, flexible tube (catheter) to inject small particles (embolic agents about the size of grains of sand) into blood vessels that feed the fibroids. The goal is to block the vessels and cut off blood supply to the fibroids. This causes the fibroids to shrink and die.

Short- and long-term effectiveness of uterine artery embolization

Most women get significant symptom relief in the first three months after treatment.

  • 73% to 90% of patients have reduced (or stopped) menstrual bleeding up to 10 years after the procedure.
  • 80% of patients report less abdominal pain and less painful periods.
  • The size of the uterus reduces by 40% to 50% after UAE.

Over time, some women need to have additional procedures to completely treat their symptoms, including surgery to remove the uterus (hysterectomy), surgery to remove the fibroid (myomectomy) or repeating the UAE.

One study shows that 14.4% of patients underwent some sort of additional treatment within three years of the initial UAE procedure. Another study reports that 28% of patients have a hysterectomy within five years after UAE and 35% within 10 years after the initial UAE procedure.

Points to consider if you are a candidate for uterine artery embolization

Most fibroid sizes and locations can be treated with uterine artery embolization. However, large fibroids can be so big that they must be removed by a different method.

You may be a good candidate for uterine artery embolization if:

  • You're premenopausal
  • You have heavy bleeding from uterine fibroids
  • You want to avoid surgery, or surgery is too risky for you
  • You want to keep your uterus

If you want to have children, talk to your doctor about the risks of UAE and how it might affect your fertility and future pregnancy. There is limited data on the affects that UAE has on pregnancy. Myomectomy is the standard of care for removing fibroids when future pregnancies are planned.

Mayo Clinic Minute: Know options for uterine fibroids

Vivien Williams: Many women have uterine fibroids.

Erica Knavel Koespel, M.D., Radiology: Uterine fibroids are benign, non-cancerous tumors that form within the uterus from an overgrowth of connective tissue and smooth muscle. They are actually very common within women who are usually premenopausal.

Vivien Williams: Dr. Erica Knavel Koespel says symptoms include heavy bleeding, anemia, difficulty emptying the bladder and pelvic pain or pressure.

Erica Knavel Koespel, M.D.: We do have a variety of options to help us treat uterine fibroids.

Vivien Williams: Treatments range from medication to surgery. One less invasive option is uterine artery embolization. Doctors access the fibroids via catheters inserted through a small artery in the groin or wrist. Once there, they fill the fibroid with contrast to make sure they are in the right spot. Then they deliver small particles that plug up the tiny arteries feeding the fibroids.

Erica Knavel Koespel, M.D.: Once these tiny arteries are cut-off or plugged up, the blood supply to the fibroid is gone and the fibroid shrinks.

Vivien Williams: For the Mayo Clinic News Network, I am Vivian Williams.

Note: This content was created prior to the coronavirus disease 2019 (COVID-19) pandemic and does not demonstrate proper pandemic protocols. Please follow all recommended Centers for Disease Control and Prevention guidelines for masking and social distancing.

May 27, 2021 See more In-depth