Is this you?

The information on this page may be relevant if any of the following describe your situation:

• Heavy or prolonged periods that change the way you plan your month.

• Pelvic pain, pressure, or a feeling of fullness in the lower abdomen.

• Frequent need to pass urine or pressure on the bowel.

• Tiredness or low iron linked to heavy menstrual bleeding.

• You are weighing your options after being told you may have fibroids.

• You would like to know whether a uterus-preserving procedure could be part of your treatment plan.

What is UAE for fibroids?

Uterine artery embolisation (UAE) is performed by an interventional radiologist. Through a small puncture in the wrist or groin, a fine catheter is guided under X-ray imaging to the arteries supplying the fibroids. Tiny particles are then released to reduce the blood supply to the fibroids.

Over the months that follow, fibroids typically shrink, and symptoms such as heavy bleeding and pelvic pressure may gradually improve. Individual response and outcomes vary.

The procedure typically takes around 60–90 minutes. Most patients stay in hospital overnight for pain management and observation.

Who may be suitable?

Fibroids are common. The Royal College of Obstetricians and Gynaecologists highlights that fibroids affect a substantial proportion of women of reproductive age, may progress over time, and can significantly affect quality of life.[1][2]

When fibroids cause symptoms — including heavy bleeding, pelvic pain or pressure, or a reduced quality of life — a range of treatment options may be considered. These can include:

• Medical treatments such as tranexamic acid or hormonal therapies

• Hormonal intrauterine devices (IUDs)

• Myomectomy

• Hysterectomy

• Uterine artery embolisation (UAE)

NICE recommends uterine artery embolisation as a treatment option for symptomatic fibroids.[3] NICE also states that patient selection should involve a multidisciplinary team, including both a gynaecologist and an interventional radiologist.

A multidisciplinary decision

At Pinhole Clinic™, the decision about whether UAE is an appropriate treatment option is made jointly between Dr El Farargy and the gynaecology team involved in your care.

Interventional radiology is a recognised consultant-led subspecialty within Clinical Radiology, with dedicated training, examinations, and standards of practice. The multidisciplinary discussion brings together complementary expertise — including imaging interpretation, procedural suitability and risk, and the wider gynaecological context — so that any treatment plan agreed is supported by both the interventional radiology and gynaecology teams, as well as by the patient.

Where a patient has not yet been assessed by a gynaecologist, this is arranged as part of the clinical pathway.

Suitability is assessed using clinical history and imaging — usually pelvic ultrasound and MRI — to ensure the clinical picture is fully understood before any decision is made.

What the procedure involves

Before the procedure, an up-to-date pelvic MRI is usually required if one has not already been performed. Where needed, this can be arranged through Pinhole Clinic™.

Uterine artery embolisation is usually performed under local anaesthetic, sometimes with light sedation, through a small puncture in the wrist or groin. An overnight hospital stay is typically recommended for pain management and observation.

Recovery and follow-up

Cramping pain during the first 24–48 hours is common and is usually managed with prescribed pain relief.

Most women return to light activity within around one week and to normal activities within approximately two weeks, although recovery times vary between individuals.

Improvement in symptoms such as heavy bleeding and pelvic pressure is generally gradual over the months following the procedure, and follow-up is arranged accordingly.

Risks and what we discuss at consultation

As with any medical procedure, uterine artery embolisation carries potential risks and complications.

The most common is post-embolisation syndrome, which may include cramping, nausea, and a low-grade fever in the days following treatment. This is a recognised part of the recovery process and is usually managed with prescribed medication.

Less commonly, risks can include:

• Infection

• Vaginal expulsion of fibroid tissue

• Non-target embolisation affecting nearby tissue

UAE may also affect ovarian function, with a small risk of earlier menopause. This is generally more relevant for women approaching menopausal age.

In some cases, symptoms may not improve sufficiently following the procedure, and additional treatment — including surgical options — may still be required.

The risks, benefits, and alternatives relevant to your situation are discussed in detail during consultation, taking into account your age, fibroid pattern, symptoms, and overall health. Individual outcomes vary.

How to be assessed

Pinhole Clinic™ accepts referrals from gynaecologists, GPs, and other healthcare professionals. Patients are also welcome to request a consultation directly.

Because decisions regarding uterine artery embolisation depend on diagnosis, imaging findings, symptoms, and the wider clinical picture, assessment is made jointly between Dr El Farargy and the relevant specialty team.

If you have not yet been assessed by a specialist in the appropriate field, we can help arrange this as part of the multidisciplinary pathway. This may be required for clinical assessment and, where applicable, for insurance authorisation.

Whether you contact the clinic directly or are referred by another healthcare professional, the aim is the same: to determine together whether a minimally invasive treatment approach is appropriate for you.

References

1. RCOG. Improving early detection and care pathways for uterine fibroids in England (position statement).
   https://www.rcog.org.uk/about-us/campaigning-and-opinions/position-statements/improving-early-detection-and-care-pathways-for-uterine-fibroids-in-england/

2. RCOG. Warns gynaecology system is failing women with fibroids, with ethnic minority women hit hardest.
   https://www.rcog.org.uk/news/rcog-warns-gynaecology-system-is-failing-women-with-fibroids-with-ethnic-minority-women-hit-hardest/

3. NICE. HealthTech guidance HTG240 — Uterine artery embolisation for treating fibroids.
   https://www.nice.org.uk/guidance/HTG240