Can Embolisation Treat My Uterine Fibroids Without a Hysterectomy?

Medicine Made Simple Summary

If you’re dealing with bothersome uterine fibroids and hearing suggestions of a hysterectomy, there’s good news: the minimally invasive procedure called Uterine Fibroid Embolization (UFE) can treat many fibroids without removing the uterus. During UFE, the blood vessels feeding the fibroids are blocked so they shrink and symptoms ease. You recover faster, avoid large scars, and keep your uterus intact. This article explains how UFE works, when it’s appropriate, what to expect, and how it compares with hysterectomy.

1. What are uterine fibroids and why do they matter?

Fibroids are non-cancerous growths in or on the muscular wall of the uterus. They’re very common—many women have them at some point during their reproductive years. Some fibroids cause no symptoms. But others make life difficult by causing heavy menstrual bleeding, low back or leg pain, pressure in the pelvis or bladder, frequent urination, fatigue due to anaemia, and in some cases difficulty conceiving.
Because fibroids can interfere with daily life, many women seek treatment. Traditionally, major surgery such as a Hysterectomy (removal of the uterus) or a Myomectomy (removal of just the fibroids) were common. These options work but involve significant recovery times and may affect fertility. UFE offers a less invasive alternative while preserving the uterus.

2. How does UFE (embolisation) work?

During UFE, an interventional radiologist inserts a thin catheter (a flexible tube) into a blood vessel—typically via the groin or sometimes the wrist. Using imaging (live X-ray or fluoroscopy), the specialist navigates the catheter to the arteries supplying your uterus and fibroids. Then, tiny particles (embolic agents) are released. These particles block the blood flow to the fibroid tissue, starving it of oxygen and nutrients. As a result, the fibroid shrinks over time and symptoms gradually improve. Penn Medicine+2MedlinePlus+2
Because the procedure doesn’t involve removing the uterus, the recovery is much faster than open surgery. Most patients go home the same day or after a short hospital stay. Many report significant relief of symptoms in weeks. Guy's and St Thomas' NHS Trust+1

3. When is UFE a suitable option and when is it less so?

UFE can be a good choice when fibroids are causing symptoms like heavy bleeding, pain, bulk-or pressure-related issues, and when you want to avoid hysterectomy. Several medical bodies recognise UFE as a valid alternative to hysterectomy for symptomatic fibroids. ACOG+1
However, UFE is not right for everyone. If you strongly wish to become pregnant in the future, you’ll need a careful discussion with your doctor because UFE may impact fertility and the uterine environment. Cleveland Clinic+1 Also, very large fibroids, specific locations, or co-existing issues (such as adenomyosis or certain uterine abnormalities) may make surgical options more advisable. Your anatomy, health status, and priorities all matter.

4. How does UFE compare with hysterectomy and myomectomy?

The key differences lie in invasiveness, recovery, long-term outcomes, and uterine preservation.

• With hysterectomy, the uterus is removed. This solves fibroid symptoms completely and eliminates the possibility of fibroid recurrence. But it ends fertility, involves major surgery, longer hospital stay, higher blood loss, and longer recovery. PubMed+1
• Myomectomy removes fibroids surgically but keeps the uterus. It preserves fertility better than hysterectomy, but is still a major operation with risks and recovery time. Studies show fewer repeat interventions compared to UFE over five years. PMC
• UFE offers symptom relief while preserving the uterus. Recovery is faster and less traumatic. Studies report that about 80-90% of women experience significant symptom improvement. Society of Interventional Radiology+1 However, the rate of needing another treatment (reintervention) over several years is somewhat higher compared to myomectomy. Kaiser Permanente Division of Research

In summary, if your goal is to relieve symptoms while keeping your uterus and minimise downtime, UFE is very attractive. If fertility and minimising future recurrence are highest priorities, you might lean toward surgical options—with full discussion.

5. What happens during and after UFE — a patient’s roadmap

Before the procedure

Your doctor will review your symptoms, imaging (ultrasound, MRI) and discuss your reproductive plans. Blood tests check kidney, liver, bleed-risk functions. You may be asked to stop certain medications (like blood thinners).

During the procedure

You’ll be taken to an interventional radiology suite, where local anaesthesia and mild sedation help you stay comfortable. The catheter enters via the groin or wrist. Imaging guides the catheter into the uterine arteries. Embolic particles are delivered to block the fibroid’s blood supply. The whole procedure takes about 1 to 3 hours. Penn Medicine

After the procedure

You’ll spend some time in recovery. You may feel cramp-like pain, nausea, or flu-like symptoms for a few days as the fibroid tissue dies and shrinks. Most women go home within 24 hours and resume light activity within a few days. Full symptom relief may take 3 to 6 months as the fibroid shrinks further. Guy's and St Thomas' NHS Trust
Regular follow-up will monitor shrinking of the fibroid, relief of symptoms, and check for any complications.

6. Benefits of UFE over surgical removal

• Shorter hospital stay and quicker return to normal life. Many women resume everyday activities within a week.
• Preservation of the uterus, which matters for many women for psychological, hormonal, or reproductive reasons.
• Lower immediate risk of major surgery-related complications like heavy bleeding, infection, wound problems.
• Effective symptom relief for most women: heavy bleeding, pressure symptoms, pain. About 8-9 out of 10 report marked improvement. Guy's and St Thomas' NHS Trust+1
• Can be performed even in patients who are higher surgical risk due to health conditions.

7. Risks, limitations and what you should know

No treatment is without risk. UFE may involve:

• Post-embolisation syndrome: pain, fever, nausea as the fibroid shrinks.
• Rarely, infection of the fibroid tissue, requiring hospitalisation or even hysterectomy (approx. 1 % risk). Yale Medicine
• Possible impact on ovarian reserve or fertility. Women under 45 face a small risk (1-2 %) of early menopause after UFE. Yale Medicine
• Higher chance of needing another procedure over time compared with surgical removal. Kaiser Permanente Division of Research
• Not all fibroids respond equally. Location, size, number matter for outcome. A detailed discussion with your IR and gynae specialist helps determine if you’re a good candidate.

8. How to decide what’s right for you

When choosing treatment, ask yourself:

• How strong are my symptoms (bleeding, pain, pressure)?
• Do I want children in future?
• What is my tolerance for risk, recovery time, recurrence chance?
• Which doctor specialises in this and what experience do they have with UFE?
  In your consultation, ask these key questions:
• What is the chance my fibroids will shrink and symptoms improve with UFE?
• What happens if UFE doesn’t work — will I still be eligible for surgery?
• What are the short-term and long-term risks of UFE in my case?
• What is the recovery time and what lifestyle/follow-up is required?
• How will my fertility or hormone function be affected?
  By having these conversations, you’ll make a choice aligned with your values and health priorities.

9. What to expect in the long term

If UFE works well, you’ll enjoy symptom relief, fewer heavy periods and less pelvic pressure. The fibroid shrinks gradually. Follow-up imaging and gynae checks assess progress.
If you were planning pregnancy, after recovery you may consult a fertility specialist. Though UFE has enabled many women to conceive, the data is less robust compared to myomectomy. 
In some cases where symptoms recur, additional treatment may be needed — but having the uterus preserved means you still have future treatment options including surgery if required.

Conclusion

Yes — embolisation can treat uterine fibroids without hysterectomy in many cases, offering less recovery time, preservation of the uterus and effective symptom relief. But it’s not the simple fix for every woman. Your anatomy, symptoms, future fertility dreams and general health all matter.
If you’re facing fibroid symptoms and discussing hysterectomy, ask your doctor: “Could UFE be right for me instead?” Seek a specialist in interventional radiology who performs UFE regularly and ask about outcomes in women like you. Bring this article to your appointment, prepare your questions, and ensure you’re fully informed.

Choosing UFE could mean returning to your life sooner, preserving your uterus and avoiding major surgery—with a plan that fits your goals.