What are the risks of UFE?
UFE is a very safe procedure, significantly safer than hysterectomy, but it is not without risks.
The realistic risks of UFE include:
Pain: most women experience pain after UFE. The procedure itself is almost painless, but after the procedure, as the fibroids are dying and your body is responding to that, and the temporary ischemia (low oxygen) in the normal muscle of the uterus causes a buildup of lactic acid in the uterus, you can have pain that can rival the pain of labor. This pain starts about an hour after UFE, gets as bad as it is going to get in 4-8 hours, and starts getting better after 12-18 hours.
To counteract that pain, we use a nerve block applied during your procedure. It is similar to the way a dentist gives you a local anesthetic before drilling a cavity, only instead of lasting just a couple of hours (like what the dentist gives you) we use a longer acting medication that provides pain relief for 24-36 hours. Long enough to get you through that worst time of pain described above.
It does not mean you feel nothing, the block converts that severe labor-like pain into more of a sensation of pressure, as if you have to urinate or defecate.
When the block wears off, you may experience increasing pain in your pelvis. This pain does not mean something has gone wrong; it is just the block wearing off. The anti-inflammatory medicine you are taking might be enough to get you through that pain, but if not, you will have the narcotic medicine you can take.
Menopause: The goal of UFE is to relieve you of your fibroid symptoms, including heavy vaginal bleeding, if that is an issue. We are not trying to put you into menopause. That said, there is a small chance you could go into menopause after UFE. And that chance increases the closer you are to your own, natural menopause. If you are under 45, the risk is less than 5%. If you are over 45 the risk is 15%. Many women over 45 tell us they would be perfectly happy to never have a period again. That is fine if that is your mindset, but we are just trying to restore normal periods, not stop them entirely.
Expulsion of fibroid tissue: If your fibroids are causing you to have heavy vaginal bleeding, you most likely have submucosal or intracavitary fibroids. These are fibroids at the surface of or within the endometrial cavity. Such fibroids can lose their attachment to the uterus after UFE and pass out through your cervix. Most of the time they pass as little flakes of tissue that might seem like a discharge or be hidden in your menses. Sometimes though, pieces of tissue will pass that look clearly different than menses or blood clot. If you have these types of fibroids, we will see them on your MRI and warn you about them. Indeed, it is one of the reasons we get the MRI, to make sure there is not one that would be unsafe for you to try to pass.
The following risk are much less likely to occur:
Infection: Developing an infection after UFE is very rare, and we take measures to prevent it from happening, including our sterile technique (the procedure room is just like an operating room), and antibiotic you will get prior to your procedure, and another you get after the procedure. But no matter what precautions we take, getting an infection is possible after any procedure.
Bleeding: Bleeding from the uterus does not happen. But you can potentially bleed from the puncture site at the top of your groin or in your wrist. Again, this is a very rare issue, but if it happens, we are prepared to help you with it.
Blood clots in your legs: This is a risk of any medical procedure or surgery. We place compression hose on your calves to keep blood from pooling in your veins during your UFE and your bedrest after the procedure. Keep them on when you leave. Once you are active, walking around at least once an hour, you don't need them. You can also minimize the risk by pumping your calf muscles every 10 minutes or so if you are reading or watching TV.
The realistic risks of UFE include:
Pain: most women experience pain after UFE. The procedure itself is almost painless, but after the procedure, as the fibroids are dying and your body is responding to that, and the temporary ischemia (low oxygen) in the normal muscle of the uterus causes a buildup of lactic acid in the uterus, you can have pain that can rival the pain of labor. This pain starts about an hour after UFE, gets as bad as it is going to get in 4-8 hours, and starts getting better after 12-18 hours.
To counteract that pain, we use a nerve block applied during your procedure. It is similar to the way a dentist gives you a local anesthetic before drilling a cavity, only instead of lasting just a couple of hours (like what the dentist gives you) we use a longer acting medication that provides pain relief for 24-36 hours. Long enough to get you through that worst time of pain described above.
It does not mean you feel nothing, the block converts that severe labor-like pain into more of a sensation of pressure, as if you have to urinate or defecate.
When the block wears off, you may experience increasing pain in your pelvis. This pain does not mean something has gone wrong; it is just the block wearing off. The anti-inflammatory medicine you are taking might be enough to get you through that pain, but if not, you will have the narcotic medicine you can take.
Menopause: The goal of UFE is to relieve you of your fibroid symptoms, including heavy vaginal bleeding, if that is an issue. We are not trying to put you into menopause. That said, there is a small chance you could go into menopause after UFE. And that chance increases the closer you are to your own, natural menopause. If you are under 45, the risk is less than 5%. If you are over 45 the risk is 15%. Many women over 45 tell us they would be perfectly happy to never have a period again. That is fine if that is your mindset, but we are just trying to restore normal periods, not stop them entirely.
Expulsion of fibroid tissue: If your fibroids are causing you to have heavy vaginal bleeding, you most likely have submucosal or intracavitary fibroids. These are fibroids at the surface of or within the endometrial cavity. Such fibroids can lose their attachment to the uterus after UFE and pass out through your cervix. Most of the time they pass as little flakes of tissue that might seem like a discharge or be hidden in your menses. Sometimes though, pieces of tissue will pass that look clearly different than menses or blood clot. If you have these types of fibroids, we will see them on your MRI and warn you about them. Indeed, it is one of the reasons we get the MRI, to make sure there is not one that would be unsafe for you to try to pass.
The following risk are much less likely to occur:
Infection: Developing an infection after UFE is very rare, and we take measures to prevent it from happening, including our sterile technique (the procedure room is just like an operating room), and antibiotic you will get prior to your procedure, and another you get after the procedure. But no matter what precautions we take, getting an infection is possible after any procedure.
Bleeding: Bleeding from the uterus does not happen. But you can potentially bleed from the puncture site at the top of your groin or in your wrist. Again, this is a very rare issue, but if it happens, we are prepared to help you with it.
Blood clots in your legs: This is a risk of any medical procedure or surgery. We place compression hose on your calves to keep blood from pooling in your veins during your UFE and your bedrest after the procedure. Keep them on when you leave. Once you are active, walking around at least once an hour, you don't need them. You can also minimize the risk by pumping your calf muscles every 10 minutes or so if you are reading or watching TV.