By Dr. Naushad Karim, Consultant Interventional Radiologist at Aga Khan University Hospital
For many women, uterine fibroids are an unseen battle, one that quietly reshapes daily life through heavy menstrual bleeding, pelvic pressure, fatigue, and emotional distress. Though fibroids are benign growths that develop in or on the uterus, their effects are often anything but harmless. In Kenya and around the world, women have long endured the discomfort, sometimes believing that hysterectomy, the surgical removal of the uterus, is their only option. But medicine has evolved, and with it has come a gentler, uterus-preserving alternative known as Uterine Fibroid Embolization, or UFE.
Fibroids are non-cancerous growths that develop from the muscle layer of the uterus and can appear in different locations, inside the uterine wall, bulging into the cavity, or projecting outward into the pelvis. Though their exact cause remains uncertain, hormones such as estrogen and progesterone play a major role in their development, and genetics often influence whether a woman is predisposed to them. Interestingly, fibroids tend to shrink after menopause when hormonal activity declines.
When it comes to treatment, there are four main approaches depending on the size of the fibroids, their location, and the symptoms a woman experiences. The first is watchful waiting, suitable for women nearing menopause or those with mild symptoms, since fibroids often shrink naturally when hormone levels drop. The second approach is medical therapy, which uses hormonal medication to reduce bleeding or temporarily shrink fibroids, though symptoms often return once treatment stops. The third is surgery, which can be either a myomectomy (removing only the fibroids and preserving the uterus) or a hysterectomy (removing the uterus completely). The fourth, and often least understood, is uterine fibroid embolization, a minimally invasive procedure that has changed the treatment landscape for many women.
UFE works by cutting off the blood supply to the fibroids, causing them to shrink and die off gradually. Unlike surgery, it requires only a tiny incision, about a millimeter wide, on the wrist or near the elbow joint. Through this small entry point, a thin catheter is guided using imaging technology into the arteries that feed the fibroids. Once in place, the doctor releases microscopic particles that block these blood vessels, starving the fibroids of oxygen and nutrients.
The procedure doesn’t require general anesthesia or hospital admission, most patients go home the same day, and within ten to fourteen days, they are back to work and living their normal lives.
This short recovery time, combined with the fact that the uterus is preserved, makes UFE a highly appealing option for women who want to avoid major surgery. It offers a pathway to healing that’s less invasive but equally effective in restoring comfort and confidence.
Not every woman, however, is an ideal candidate. UFE is best suited for women experiencing heavy menstrual bleeding, pelvic pain, or bulk symptoms such as abdominal swelling or urinary frequency, and who wish to avoid hysterectomy. It may not be recommended for those with extremely large fibroids that distort the uterus, those with ongoing pelvic infections. In such cases, a myomectomy may be more appropriate. Each case is unique, a joint evaluation by a gynecologist and an interventional radiologist helps determine the best path forward.
At Aga Khan University Hospital, the procedure is performed using advanced fluoroscopic imaging, allowing the interventional radiologist to visualize the uterine arteries in real time. This precision ensures that only the fibroid-supplying vessels are targeted, preserving healthy tissue. While some discomfort and a bit of pain is expected after the procedure, we usually administer painkillers to keep patients comfortable. Minor side effects such as fatigue, mild fever, or light bleeding may occur for a few days, but these typically resolve quickly.
Every medical procedure carries some degree of risk, but serious complications after UFE are rare. Possible risks include infection, allergic reaction to contrast dye, or, in very uncommon cases, damage to nearby organs. Patients are thoroughly evaluated before the procedure to ensure they are physically and mentally prepared. We take time to explain what the patient should expect, how the procedure works, and how recovery will feel.
One of the most common questions women ask is whether UFE affects fertility. Because the uterus remains intact, conception is still possible, with research showing 90% successful conceptions after the procedure, though the likelihood depends also on individual circumstances such as age, fibroid size, and uterine health. Pregnancies have been documented after UFE, but research is ongoing to better understand long-term fertility outcomes.
While the treated fibroids shrink and rarely grow back, new fibroids can develop because the uterus itself remains capable of forming them. Still, most women experience lasting relief from symptoms such as heavy bleeding and pelvic pain.
We have made significant progress in offering minimally invasive treatments like UFE. Aga Khan University Hospital has been at the forefront, performing the procedure for over fifteen years with excellent outcomes. Yet, accessibility remains a challenge. UFE is relatively costly because it requires specialized equipment and materials. Awareness is another barrier, many women, and even some healthcare providers, are not yet familiar with this option. He adds that greater investment in interventional radiology and increased public education could make UFE more widely available and affordable.
UFE represents more than just medical innovation, it’s a path to restoring quality of life. You don’t have to lose your uterus to regain your health. UFE offers women a safe, effective alternative that allows them to heal and continue living fully. With greater awareness, access, and education, women can reclaim control over their health and their bodies. For many, UFE is not just a procedure, it’s a chance to live without pain, fear, or limitation, and to step forward into a life renewed.
