For a long time, painful or bleeding fibroids were only removed surgically, whereby either only the fibroid was removed from the uterine wall or the entire uterus. Nowadays, myoma embolization is available as a non-surgical alternative.
An interventional radiologist (FMH specialist with special training in minimally invasive procedures) performs myoma embolization, which is covered by health insurance. This procedure was first carried out in 1995 and has proven itself millions of times over since then. The complaints could be treated successfully and sustainably in 80-90% of women.
The procedure is not performed under general anesthesia like conventional uterine surgery, but usually with painkillers and sedatives. Instead, spinal anesthesia or uterine nerve anesthesia can be used, as in childbirth. Thanks to local anesthesia, a hospital stay of one night is usually sufficient.
A thin catheter is inserted into the artery using a small skin puncture in the groin. In order to find the correct route to the uterine arteries, X-rays can be taken repeatedly during the procedure. These also show the arterial branches that supply the fibroid with blood. Fine plastic particles the size of a grain of sand are injected into the fibroid, which stops the blood supply to the fibroid and causes it to shrink. Although the symptoms will already decrease in the first month, the maximum shrinkage of the treated fibroid only occurs after three to six months. Most women resume light work after a few days and return to their usual activities within one to two weeks. The recovery time is therefore shorter than after uterine surgery.
Common side effects after the procedure are pain and cramps, for which painkillers are used. Occasionally, fever or nausea occur after the procedure as a sign of fibroid decay, but both can be treated with medication. A small number of patients have to be treated with antibiotics due to infections. In a few patients, especially those older than 45 years, menopause may occur after embolization. The uterus is damaged in around one percent of operations, meaning that it has to be surgically removed after all.
As the uterus is not removed during myoma embolization, many women have become pregnant after the procedure. However, a scientific comparison between fertility after myoma embolization and after surgical myoma removal (myomectomy) showed that embolized patients had slightly fewer successful pregnancies. Myoma embolizations should therefore only be performed on young women who wish to have children if other methods have failed or are not feasible.
As a patient, you cannot register directly for a consultation. Please get a referral from your primary care physician, specialist.
University Hospital Zurich
Interventional Radiology
Rämistrasse 100
8091 Zurich