Varicocele and uterine fibroids
Uterine fibroid embolization
Through a 2 mm access at the groin (femoral artery), the vessels feeding the fibroid are closed, causing it to progressively shrink. No scars, uterus preserved.
How it is performed
From the femoral artery at the groin, a very thin catheter is guided to the uterine arteries. Injecting microparticles selectively interrupts the blood supply to the fibroids, which undergo infarction and progressively shrink in volume over the following months, while healthy uterine tissue regains its blood supply. The uterus is preserved and there are no surgical scars.
Who it is for
- Symptomatic fibroids with heavy bleeding, anaemia, pain or a feeling of pelvic pressure
- Wish to avoid hysterectomy or myomectomy
- Contraindications to, or refusal of, surgery
Recovery
One night of observation or day-case admission. Cramping similar to menstrual cramps is expected in the first 24-48 hours, controlled with pain medication. Return to activities in about one week; symptoms and fibroid volume improve over 3-6 months.
Conditions treated in this area: chronic pelvic pain and pelvic varicocele, uterine fibroids with pain and bleeding.
Scientific evidence
The Cochrane review of randomised trials comparing embolization with surgery shows comparable patient satisfaction, with a shorter hospital stay and faster return to activities, against a higher likelihood of needing a further procedure over time. Gynaecological guidelines recognise it as an established option for symptomatic fibroids.
References on PubMed
- Uterine artery embolization for symptomatic uterine fibroids
Gupta JK, Sinha A, et al. — Cochrane Database Syst Rev, 2012 · PMID 22592701
- Updates in uterine artery embolization for leiomyomas
Kim A, Arabkhazaeli M, et al. — Curr Opin Obstet Gynecol, 2020 · PMID 32487798
- The management of uterine leiomyomas
Vilos GA, Allaire C, et al. — J Obstet Gynaecol Can, 2015 · PMID 25767949
Published data describe average results in groups of patients and are not a prediction of an individual outcome. The indication for treatment must always be assessed during a consultation.
Risks, costs and opinions
The three questions patients ask most often before deciding, with clear answers.
What are the risks of uterine fibroid embolization?
It is a minimally invasive endovascular procedure performed as a day-case, under local anaesthesia. The most common issues are transient: a small bruise or soreness at the access point, and in some cases a post-embolization syndrome with pain, a feeling of being unwell or a low-grade fever in the following days, manageable with medication. Relevant complications (contrast reaction, unintended embolization of nearby vessels, problems at the puncture site) are rare and are discussed one by one during the consultation, with the informed consent in hand.
How much does the uterine fibroid embolization cost?
The cost depends on the setting in which the procedure is performed: some treatments are available through the National Health Service or under agreement, others privately or through insurance. The quote is given clearly before scheduling the treatment, and includes the assessment, the procedure and the planned follow-up. During the consultation I tell you which pathway is available in your case: you do not have to decide before knowing the cost.
Does it really work? What patients and the literature say
The most frequent questions are "does it really work?" and "how long does the result last?". The honest answers come from the scientific literature cited on this page, not from online stories: they describe average results in groups of patients and do not guarantee an individual outcome. Reviews and experiences found in forums concern cases different from yours, often with different indications and techniques. During the consultation we review your imaging and I tell you frankly whether you are a good candidate, what alternatives exist and when another pathway is preferable.
Want to know if it is right for you?
At the first consultation we review your clinical history and previous imaging together.