MedStar Georgetown University Hospital is one of the leading centers in the world for uterine artery embolization (UAE). Since 1997, nearly 4000 women have been treated at MedStar Georgetown, benefiting from the most advanced care available in the field. The program is led by James Spies, MD, MPH, a leading international authority, and Theresa Caridi, MD. Together, Drs. Spies and Caridi have published over 100 scientific articles and numerous medical text chapters on the subject.
What is Uterine Artery Embolization?
Uterine Artery Embolization (UAE) is a minimally invasive therapy designed to treat uterine fibroids, adenomyosis, and other conditions of the uterus without surgery. When used to treat fibroids, it is often referred to as Uterine Fibroid Embolization (UFE).
After sedation and local anesthesia, a thin catheter is placed in an artery either at the top of the leg or in the left wrist. It is advanced into the uterine artery using x-ray guidance. Small beads are injected to block the arteries that supply the fibroid or other target. The fibroid or other growth will shrink and shrivel into scars. Symptoms typically improve substantially.
The procedure takes 1 to 1.5 hours. Patients do not experience pain during the procedure, but typically do experience moderate pain for several hours afterward. Discomfort is managed with medication and usually resolves after 6 to 8 hours.
About 90% of patients who undergo UAE will experience substantial improvement or complete relief of symptoms within 2 to 3 months. Because this therapy does not require surgery, it is associated with lower risk of complication and faster recovery times.
What are the potential side effects?
Complications are infrequent and most are not serious. Possible side effects include loss of menstrual cycle in women approaching menopause, the passage of fibroid tissue, uterine infection or injury, and blood clots. These side effects are extremely rare.
Many patients are concerned that a malignant tumor may be misdiagnosed as a fibroid or adenomyosis. Cancerous uterine tumors, called leiomyosarcomas, occur in only about 1 in 500 cases. Our clinicians screen patients prior to UAE using a low-risk MRI scan. MRI scans can often detect concerning uterine tumors. The very small percentage of patients with growths that appear potentially malignant are advised to opt for surgery.
After UAE, patients undergo another MRI to be certain that their condition has been successfully treated. If that is the case, then the risk of malignancy is very small.
Can I become pregnant after UAE?
It has often been suggested that infertility and/or repeated miscarriage can be caused by fibroids and similar conditions, but there is limited evidence to support this connection. UAE has not been used as a fertility procedure.
Although there have been many patients who have become pregnant after uterine embolization, women seeking to become pregnant should first consider other options. For fibroid patients, the first choice is typically myomectomy. For patients who are not good candidates for myomectomy, embolization may be an acceptable choice.