For women who’ve heard of uterine fibroid embolization — and want to see exactly what it involves
Every fibroid has a supply line. UFE shuts it off.
Uterine fibroid embolization is a same-day, non-surgical procedure. Through a
pinhole in the groin, an interventional radiologist blocks the arteries
feeding your fibroids. Starved, they soften and shrink. No incision, nothing
removed — your uterus stays exactly where it is. Done in our own IR suite,
in our office, and covered by most insurance plans, including Medicare and
Medicaid.
Covered by most insurance, including Medicare & Medicaid No referral needed for your initial consultation Every patient goes home the same day More than 300 UFE procedures performed here
Performed by the physician, start to finish
Arthur S. Joseph, DO, MPH, board-certified vascular and endovascular radiologist, performing a uterine fibroid embolization in our angiography suite.
You’ve heard the name. Now see the thing itself.
Maybe you came here from our uterine fibroids page, where UFE is the option nobody offered you — and before you take it seriously, you want to know what “a procedure” actually means.
Maybe your OB/GYN finally mentioned it, or a friend had it done — or you found the letters U-F-E at 2 a.m. in a fibroid forum and thought: this sounds too good. What’s the catch?
This page is the full walkthrough: what happens on procedure day, what goes into your body, what the first night honestly feels like — and a documentary of a real UFE performed here, following one of our patients through her whole treatment. Judge it with your own eyes.
The procedure
What UFE actually does.
Fibroids are muscle tumors — almost never cancer — and they behave like
any growing tissue: they live on blood supply. Give a fibroid blood
and it grows. Take the blood away and it shrinks. That’s not a metaphor.
It’s the entire procedure.
Through a pinhole in the groin, an interventional radiologist guides a
catheter thinner than a phone-charger cord into the uterine arteries — the
supply line — and releases microscopic particles into the branches feeding
each fibroid. The particles lodge there and block the flow.
Starved, the fibroids soften and shrink over the following weeks and months. The
bleeding eases. The pressure lets up.
Notice what UFE is not: it’s not surgery. Nothing is cut and
nothing is removed. A hysterectomy solves fibroids by taking out the organ that has
them. UFE solves them by unplugging them — all of your fibroids, in one
procedure — and your uterus stays exactly where it is.
Animation courtesy of Merit Medical, the manufacturer of the embolic microspheres we primarily use.
What UFE is not
Three limits, stated before anything else.
The first night is the hard part
As the fibroids react to losing their blood supply, the cramping is very real
— for most women about 18 hours, the first night. We counsel every patient up
front, send you home with real pain medication and a plan, and call you the next
morning. Nine out of ten of our patients are off narcotic pain medication by that
call.
Fibroids can come back
Regrowth risk is strongly age-dependent — the closer you are to menopause,
the lower the odds. It’s a number we personalize at your consultation, not a
promise on a website.
It isn’t for every fibroid
Fibroids larger than 17 centimeters need a myomectomy or hysterectomy to resolve
the bulk — we’ll refer you for exactly that. And if your symptoms come
from something other than fibroids, we’ll tell you.
Limits first, results second — that’s the order you
deserve. Now watch it actually happen.
Every patient’s story is their
own. Results vary. These are real ARV Centers patients, sharing their experiences with
their permission. Prefer reading? Everything in the videos is covered on
this page — and in more detail.
Procedure day
What happens, step by step.
1
You get comfortable. An IV delivers sedation — you’re relaxed and drowsy, breathing on your own. Not general anesthesia. The procedure itself doesn’t hurt; discomfort during it is rare.
2
The pinhole. The doctor numbs a spot at the top of your thigh and makes a pinhole opening in the artery. No incision, no stitches — a small bandage covers it afterward.
3
The map. A catheter travels to the uterine arteries. X-ray dye flows, and the arteries feeding your fibroids light up — the same map you can watch the doctor navigate in the documentary above.
4
The treatment. Microscopic particles go into the branches feeding the fibroids — both sides, all of your fibroids in one procedure — while the healthy arteries around them keep flowing.
5
Sealed and resting. The catheter comes out, the pinhole is sealed, and you recover with us for about an hour.
6
Home the same day. Your driver takes you home — no driving the rest of the day; it’s the sedation, not the procedure. You leave with real pain medication, a plan for the first night, and the on-call doctor’s cell number. We call you the next morning to check on you.
Where it happens
Our own angiography suite, in our office — not a hospital operating room.
Every UFE here happens in our own IR suite — not a hospital. Every patient
goes home the same day, after about an hour of recovery. In the randomized trial
against surgery, embolization patients spent one day in the hospital instead of
five³ — in our office, there’s no hospital at all. Plan on being with
us three to four hours all told — you’ll fast for the eight hours before
(clear liquids and black coffee are fine up to two hours ahead), and you’ll
bring a driver.
The honest part comes that night: the cramping is real, and we prepare you for it
— before the procedure, not after. How hard it is varies genuinely from woman
to woman. Women who’ve been through labor often recognize the cramps and
manage them well; women who haven’t sometimes find them harder than expected.
Either way, you have a plan, real medication, and the doctor’s cell number.
Don’t take our word for any of this: the exact instruction sheets our
patients take home are right here. Read them before you ever book anything —
pre-procedure instructions
(PDF) and post-procedure
instructions (PDF) — down to the hour-by-hour pain-medication schedule
and the heating-pad advice for the first night.
What goes in — and what stays
The particles stay put. That’s the point.
The particles are soft, biocompatible medical microspheres
smaller than a grain of sand, delivered sterile. They’ve been
FDA-cleared since 2000 — and cleared specifically for uterine fibroid
embolization since November 2002, on the strength of a prospective clinical
study.⁶ They lodge in the arteries feeding the fibroids and stay there, so the
supply line stays closed — while the healthy arteries around them keep
flowing.
“And the fibroid itself — doesn’t the dead
tissue just stay in there?” Fair question — most women ask it.
The fibroid doesn’t rot or float loose. Your body does what it does with any
tissue it no longer feeds: it breaks it down and scars it in, the way a bruise
resolves. In some cases, small fibroid fragments pass naturally. Location matters,
and your doctor will tell you what to expect for your specific fibroids — we
don’t sugarcoat it.
The pictures from the procedure
You can see it work, on the table.
Three runs from a uterine fibroid embolization performed here, in the
order they were taken. This is the same live X-ray your doctor watches — which is why
nobody has to wait and wonder whether the treatment reached the fibroid. It’s
confirmed before the catheter comes out.
1The fibroid, lit upDye runs down the uterine artery, and
past it the fibroid appears as a dark blush of fine, tangled vessels. That blush is the
blood supply the fibroid built for itself — the reason it grows, and the reason
you bleed. It is also the target.2The same fibroid, devascularizedAfter the microspheres go
in, the blush is gone. The fibroid is cut off from its blood supply, and starved tissue
undergoes ischemic change — the fibroid softens, shrinks and dies. The uterus
keeps its own supply and keeps working.3The confirmation runA last injection one branch upstream,
into the main anterior division of the internal iliac artery. The dye refluxes back into
the surrounding vessels rather than going forward — no flow left to the fibroid.
That’s the picture the doctor is looking for before finishing.
Angiograms from a uterine fibroid embolization performed at ARV
Centers, San Antonio. Patient identifying information removed. One patient’s images;
individual results vary — the study numbers below are the fairer way to set
expectations.
The published evidence
What the studies show.
A few of the papers behind these numbers — embolization compared with hysterectomy and myomectomy, a 2025 fertility meta-analysis, and the ACOG practice guidance. Full citations below.
9 in 10
women who have uterine fibroid embolization get significant improvement, or their
symptoms go away completely — the figure the Society of Interventional
Radiology gives patients.⁸
96%
had their heavy bleeding improve — in 1,285 women treated
in an office-based outpatient setting, the same way we do it here.⁷
94%
had their pelvic pain improve — and 94% their
bulk symptoms, the pressure and swelling. Fatigue improved in 94%,
urinary frequency in 92%.⁷
2,112
women in the largest study ever done — 27 practices across the U.S.
Symptom and quality-of-life scores improved by more than 40 points, into the
normal range, holding at three years.⁴
2 in 3
never needed a hysterectomy — in the only randomized trial that followed
women for ten full years. Their quality of life matched the women who’d had
one.²
Zero days
in the hospital — against a five-day stay for surgery in the randomized
trial, and a faster return to work.³ UFE happens in our own IR suite, and
every patient goes home the same day, after about an hour of
recovery.
78%
of embolization patients said — ten years later — that they were
satisfied with their choice.²
Level A
the highest grade of evidence ACOG gives. The OB/GYNs’ own
professional college recommends UFE at that level for women who want to keep their
uterus — the same tier it gives hysterectomy.⁵
And these aren’t one clinic’s numbers. The
symptom-relief figures line up across two decades of independent series — 200
patients at Georgetown, 538 women in the Ontario UFE trial — landing in the same
80–90% range for bleeding, bulk, urinary urgency and period pain.⁹
The strongest endorsement isn’t ours: ACOG — the
American College of Obstetricians and Gynecologists, the OB/GYNs’ own
professional college — recommends uterine artery embolization at its highest
evidence level for women with fibroids who want to keep their uterus.⁵
What we won’t claim: permanence, or a promise that
fibroids never return. Regrowth risk is age-dependent, and it’s a number we
personalize at your consultation — honestly. And when a myomectomy or another
path genuinely fits your situation better, we’ll tell you so. That’s how
we practice.
Sources: 1. Ravina et al., Lancet 1995. 2. de Bruijn
et al. (EMMY 10-year randomized trial vs hysterectomy), Am J Obstet Gynecol
2016. 3. Edwards et al. (REST randomized trial), N Engl J Med 2007.
4. Goodwin et al. (FIBROID Registry, 2,112 patients), Obstet Gynecol 2008.
5. ACOG Practice Bulletin, Management of Symptomatic Uterine Leiomyomas, 2021
(Level A recommendation). 6. FDA 510(k) K021397, Embosphere Microspheres for uterine
fibroid embolization, cleared Nov 22, 2002. 7. Geschwind, Afsari, Nezami et al.,
Diagnostics (Basel) 2025;15(6):739 — 1,285 women treated with UAE in an
ambulatory (office-based) setting: bleeding improved in 96%, pelvic pain in 94%,
bulk-related symptoms in 94%, fatigue in 94%, urinary frequency in 92%.
8. Society of Interventional Radiology, patient information on uterine fibroids and UFE
— “approximately nine out of 10 women who undergo uterine fibroid embolization
will experience significant improvement, or their symptoms will go away completely.”
9. Corroborating series: Spies et al., Obstet Gynecol 2001;98(1):29–34
(200 patients — heavy bleeding improved 90%, bulk symptoms 91% at one year);
Pron et al. (Ontario UFE Trial), Fertil Steril 2003;79(1):120–127
(538 women — menorrhagia 83%, bulk/size 84%, urinary urgency 86%,
dysmenorrhea 77%).
Candidacy
Who this is for — and who it isn’t.
UFE may be right for you if:
Imaging has confirmed fibroids — or we’ll get the imaging
Heavy bleeding, clots, or planning your life around your period
Pressure, bloating, or a belly that makes you look pregnant
Exhaustion or anemia from the bleeding
You want to keep your uterus
You’ve been told a hysterectomy is your only real option
You want to avoid surgery, or you’re not a good candidate for it
It may not be right if:
Your symptoms come from something other than fibroids (we’ll check)
Your largest fibroid is over 17 centimeters — at that size only a myomectomy or hysterectomy resolves the bulk, and we’ll refer you for exactly that
We turn away patients who aren’t candidates for what we do.
Routinely.
Planning a pregnancy someday? That doesn’t rule you out
— it changes the conversation, and we’d rather have it honestly than
around it. Tell us first. The full fertility discussion — the real numbers,
by age — is on our uterine fibroids page, and
it continues in person, with your imaging in front of us.
Your care team
The doctors who perform UFE here.
Uterine fibroid embolization at ARV Centers is performed by our Board Certified
Vascular and Interventional Radiologists, in our own angiography suite. One number
worth asking any doctor before any procedure: how many times have you done
this? Here’s ours: more than 300 uterine fibroid
embolizations. You’ll meet the doctor performing your procedure at
your consultation — and we’re glad to coordinate with your OB/GYN before
and after.
When you go home, you take the on-call doctor’s cell phone number with you.
Not an answering service — the doctor.
And you don’t have to wonder whether to bother us: we call you the next morning
to check in. Every patient, every procedure.
Before you leave, you’ll get this card
Your procedure:
On-call doctor:
Cell phone: written by hand, before you walk out
Call me if anything worries you.
Straight answers
Questions patients actually ask.
“Will I be awake? Does it hurt?”
You’re under IV sedation — relaxed and drowsy, breathing on your own. Not general anesthesia. The procedure itself doesn’t hurt — discomfort during it is rare. The honest pain conversation is about the first night afterward, and it’s covered in plain view above — along with the plan we send you home with.
“How long will I be at your office?”
UFE is an outpatient procedure in our own IR suite — not a hospital. Plan on being at our office three to four hours all told, prep included. After the procedure you recover with us for about an hour, and every patient goes home the same day. Bring a driver: the sedation means no driving until the next day, no exceptions.
“Wrist or groin?”
We use the groin. Both are genuine routes to the same arteries, and some centers prefer the wrist — so if you’ve read about wrist access, that’s why. Either way it’s a pinhole: no incision, no stitches.
“What if the cramping is worse than I expected?”
You won’t be guessing alone at 2 a.m. You go home with the on-call doctor’s cell number, real pain medication, and a plan we built with you before the procedure — and we call you the next morning. In our practice, nine out of ten women are off narcotic pain medication by that call.
“When can I go back to work?”
In our experience, most of our patients are back to normal life in one to two weeks — many sooner. The first night is the hard part; after that it’s typically period-like cramps and fatigue that taper off. We’ll give you an honest read for your situation at your consultation.
“How soon will I know it worked?”
Bleeding usually improves within the first cycles. Most women notice significant change in the first four to six weeks — if you could feel the fibroid before, you’ll often feel it soften and shrink. The most substantial shrinking happens between six and twelve months.
“What if fibroids grow back — can UFE be repeated?”
Regrowth risk is strongly age-dependent, and for many patients it’s low — a number we personalize at consultation. In the 2,112-woman registry, fewer than 1 in 10 women had gone on to a hysterectomy three years after the procedure, and fewer than 1 in 50 chose a repeat embolization.⁴ If regrowth does happen, a repeat UFE — or another path, if it genuinely fits better — is a conversation we’ll have with real numbers on the table.
“I want children someday. Is this off the table?”
No — but tell us first, because it changes the conversation. The honest, number-by-number fertility discussion — including what the largest analysis to date shows by age — lives on our uterine fibroids page, and we’ll have it with you in person, with your imaging in front of us.
“How many of these have you actually done?”
More than 300. That’s exactly the right question, by the way — we’d encourage you to ask it of any doctor recommending any procedure. We’ll never be offended by it.
“Is this experimental?”
No. The technique was pioneered in Paris in the 1970s to stop life-threatening bleeding after childbirth, and first used for fibroids in the early 1990s, with results published in The Lancet in 1995.¹ The microspheres have been FDA-cleared since 2000 — for uterine fibroids specifically since 2002.⁶ It has been tested against both hysterectomy and myomectomy in randomized trials published in the New England Journal of Medicine, with ten-year follow-up data² ³ — and ACOG, the OB/GYNs’ own college, recommends it at its highest evidence level for women who want to keep their uterus.⁵
“Is it covered by insurance?”
Yes — most plans cover UFE, including Medicare and Medicaid, and we’re in-network with most insurance plans. We do a complimentary benefits check before any procedure. No surprises.
Free patient guide
Not ready to call? Take the guide instead.
Our free fibroid guide explains what fibroids are, every treatment option — from
watchful waiting to hysterectomy, including the ones nobody mentioned — and the
questions worth asking any doctor, including us. Written by our physicians. No appointment
required, and no follow-up phone call unless you ask for one.
We’ll email your guide plus occasional patient education.
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You’ve now seen more of this procedure than most patients ever do. The next step is a conversation, not a commitment.
You’ll sit with a physician — not a salesperson. Bring your imaging if you have it, and every question you’ve been saving. You’ll leave knowing whether UFE fits your fibroids — and what we’d do if you were family. Call us directly, or send this form and we’ll call you to schedule. We do a complimentary benefits check before any procedure. No surprises.