Having a fibroid embolisation

Fibroids are non-cancerous growths in the wall of the womb. Sometimes, they become very large. Fibroid embolisation is a minimally invasive procedure, which blocks the arteries that supply blood to the fibroids and makes them shrink.

Before the procedure

Before your procedure, we need to take pictures of the womb. This allows us to check the size, number and place of the fibroids. Your gynaecologist usually arranges for you to have an ultrasound or MRI scan.

Our interventional radiology (IR) coordinators team arranges a date for you to have a pre-assessment appointment. At this appointment, we explain all the information that you need to know before the procedure. You also have a blood test.  

It is important to tell your gynaecologist or pre-assessment nursing team if you:

• become pregnant or think that you could be pregnant
• have any signs of a vaginal infection, such as itching or a smelly discharge (leaking fluid)
• have recently had any illnesses or medical conditions
• take any medicines that help to prevent blood clots

Preparing for the procedure

There are some things that can help you to prepare for a fibroid embolisation procedure. Our pre-assessment nursing team can talk to you about them in more detail at your pre-assessment appointment.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to have a fibroid embolisation, we will ask you to sign a consent form. This says that you understand what is involved and agree to have the treatment.

You can read more about our consent process.

On the day of the procedure

On the day of your fibroid embolisation procedure, please arrive 15 minutes before your appointment time. This allows time to prepare.

We put a small plastic tube called a cannula into a vein in your hand or bottom half of your arm (forearm). We can then give your medicines through the cannula during the procedure.

We give you a hospital gown to wear and then take you to the interventional radiology (IR) department.

You get a chance to ask the IR doctor any questions that you may have. We ask you to sign the consent form confirming that you agree to have the procedure.

During the procedure

Most people have the procedure under conscious sedation. This is when we give you medicines through the cannula in your hand to relax you and ease your pain.

You often forget most of the procedure afterwards. However, you are awake enough to breathe for yourself and communicate with staff during the procedure.

What happens during the procedure

1. We position you on an X-ray table.
2. Sometimes, the IR doctor may place a fine needle in front of your lower spine through your lower tummy wall. They can then give you a local anaesthetic medicine through the needle and directly into the nerves supplying the pelvic area. This medicine makes the part of the body to be treated numb and free from pain.
3. We put a fine, flexible plastic tube called a catheter (about as thick as a spaghetti strand) into an artery in your left wrist or right groin.
4. Using X-ray monitoring to check its position, the IR doctor guides the catheter into both of the arteries in your womb (right and left).
5. When the catheter is in the correct position, the IR doctor injects fluid containing tiny particles through the catheter. This fluid flows into the arteries of the womb and blocks them.
6. When the procedure is finished, the IR doctor removes the catheter. They use a closure device or press on the area where the catheter was in place for about 10 minutes to stop any bleeding. You do not need stitches but we cover this area (the puncture site) with a small dressing.

The particles used in this procedure are made from a plastic-like material called polyvinyl alcohol. They are about the size of grains of sand and stay in your body permanently. In over 30 years of use, the particles have not shown any harmful effects.

How the procedure feels

To control the pain, we give you a painkiller as a suppository a few minutes before the procedure. This is a small cone or tube that we put into your bottom. It melts to release pain medicine.

We also give you the conscious sedation medicine when you are on the X-ray table at the start of the procedure. In some cases, the IR doctor injects a local anaesthetic to make the area numb and free from pain.

Although you do not feel much pain during the procedure, you can expect some cramp-like pain similar to period pain afterwards. The level of pain is different for each person. We give you strong painkillers to help during your overnight stay on a ward.