Uterine fibroid embolization is a minimally invasive, effective treatment with a very short recovery time

Uterine fibroids can cause heavy uterine bleeding and fertility problems, among other symptoms. Gynecologists and interventional radiologists at Juaneda Hospitals evaluate each case and provide personalized treatment to women with symptomatic fibroids.

The Interventional Radiology Unit at Juaneda Hospitals, led by Dr. Anna Alguersuari, performs uterine fibroid embolization—a minimally invasive therapy that involves blocking the arteries supplying these benign tumors, effectively reducing their size permanently.

Uterine fibroid embolization is a procedure performed by interventional radiologists to treat this condition. Uterine fibroids are the most common benign tumors in women. They can cause heavy menstruation and fertility problems, among other issues. The procedure involves blocking the uterine arteries that supply the fibroids using a catheter. Embolization is very aggressive towards the fibroid but minimally invasive for the patient. Within days, the patient recovers, and within months, menstruation normalizes along with other associated symptoms. Dr. Anna Alguersuari, director of the Radiology Service at Juaneda Hospitals and the Interventional Radiology Unit, explains this condition and its treatment options.

–What are uterine fibroids?

–They are the most common benign tumors in women. Often asymptomatic, they usually don’t require treatment. However, they can cause symptoms like heavy menstrual bleeding, leading to anemia and impairing daily activities. Additionally, as they grow, they may compress the bladder, causing frequent urination; compress the rectum, making bowel movements difficult; or affect the cervix and vagina, causing pain during intercourse. Symptomatic or asymptomatic fibroids can also hinder healthy pregnancies since the uterus needs to expand during pregnancy. Fibroids, which occupy space and distort the uterine structure, can prevent or complicate embryo implantation or lead to miscarriages during pregnancy. In such cases, fibroids must be treated.

–How are fibroids treated?

–I like to approach fibroids as a condition requiring a multidisciplinary approach. Gynecologists and interventional radiologists must coordinate to develop the therapeutic strategy that best suits each woman. Not all fibroids are treated the same way. Each technique is effective in specific cases but has limitations. For example, if a fibroid can be removed via myomectomy—a procedure performed by gynecologists—that is often the treatment of choice. This approach solves the problem in a minimally invasive, definitive way with a quick recovery. However, when fibroids are very large or multiple, this technique may not be feasible.

–What other options are available?

–Another option is ablation, a minimally invasive technique. It involves inserting a needle into the fibroid and burning it. Recovery is incredibly fast, and the results are good. However, recurrences are possible, and it has similar limitations to myomectomy regarding the size or number of fibroids, which are highly vascularized with many blood vessels, making complete destruction difficult for large or multiple fibroids.

–This brings us to embolization.

–Exactly. Although there are other techniques, uterine fibroid embolization—performed by interventional radiologists in collaboration with gynecologists—enables the treatment of large or multiple fibroids globally and effectively. This is why I emphasize the importance of a multidisciplinary approach. It is essential to avoid hysterectomy—removing the uterus—which has been the traditional option. Today, we know the uterus must be preserved at any age due to its significant role in hormonal balance and cardiovascular health in women. With procedures like uterine fibroid embolization, we achieve this preservation.

–What does the procedure involve?

–It involves embolizing the uterine arteries, a procedure we interventional radiologists perform. We access the arteries via the femoral artery (in the groin) or the radial artery (in the wrist) and navigate through the vessels to the uterine arteries—one on each side of the uterus. These U-shaped arteries are large, easy to identify, and accessible with a catheter. Once inside, we block the arteries, cutting off the fibroid’s blood supply, which significantly reduces its size.

The immediate effect is the normalization of previously heavy menstruation, achieved in 95% of cases within one to three months post-procedure. Over time, usually within a year, the fibroid shrinks by 50%, eliminating symptoms caused by space occupation and allowing proper ovum implantation and uterine growth during pregnancy.

–Is this procedure aggressive?

–It is very aggressive towards the fibroid but minimally invasive for the patient. The procedure requires only a two-to-three-day hospital stay, and most patients resume normal activities within a week. We provide an almost always definitive solution to a health problem that often affects women for years before finding relief. Additionally, the recurrence rate is low, between 10% and 15%.

–Are there cases where embolization is not recommended?

–Each case must be evaluated individually by a multidisciplinary team. In cases where a fibroid obstructs pregnancy, if it is small and solitary, both myomectomy and radiofrequency ablation are good options. However, when there are many small or large fibroids that cannot be individually removed, embolization can treat all of them simultaneously and globally. In these cases, embolization is the best option, as it addresses fibroids of any size or number while preserving uterine integrity.

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