Why Sometimes UFE Doesn't Bring Relief (And What to Do About It)
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- Опубліковано 26 сер 2024
- It's rare, but it happens: UFE doesn't bring relief, at least at the beginning.
Sometimes, Dr. John C. Lipman of Atlanta Fibroid Center sees women, who had UFE with a different interventional radiologist and didn't have expected results.
In this video, Dr. John Lipman explains why this may be happening and what you should do about it.
To learn more about uterine fibroid embolization, visit:
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To make an appointment with Dr. John Lipman, call 770-953-2600 or request an appointment online:
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I am from Pakistan. My UFE was done on 19 July 2023.. I had heard that there is a lot of pain but during the procedure I didn't feel anything at all when the particles were put in I felt a burning sensation the whole procedure took about half an hour then I was shifted to the ward I started having cramps which lasted for about an hour but were bearable then I was put on painkiller drops and I fell asleep the cramps stopped but it was all bearable as I heard the pain was unbearable. Thank God it was nothing. The next day I was sent home. The pain is getting less and less with each passing day, but no weight lifting for two weeks. The heating pad helped me a lot in this whole process. Whenever I got cramps, I would put the heating pad on and it would give me a lot of relief.
How are you feeling now?
Aoa. Hina mera bhi embo hwa aik saal phly. But abhi tk concive nhi kia main ny. Aik big size fibrod naaf k pas hy mjhy. Feel bhi hoti hy. But dr ka kehna hy wo dead hy. Krachi sy krwaya tha main ny dr. Imtyaz sy embo. Ap ny kanha sy krwaya? Kuch btain apny bary main. Periods ab mery behtr hain.. Cramps nhi hoty mjhy. Na zyada bleedind hoti. Back pain bhi nhi hota. Allah ka kram hy ye bht. Kafi chang aya ye. But pait mera km nhi hwa. 7 month pregnent lgt main
Hi yar, m also from Pakistan... getting ufe next week..so nervous..plz tel me how are you now
I'm also from Pakistan.plz tell me your fibroids size reduce or how you feel now?
@@kirankhalid1881don’t worry Alhamdullilah you are feeling a lot better .from your symptoms it looks like things are working . Trust Almighty for blessing you baby. Don’t feel anxious, stay busy , shift your focus and you will see how good you feel overall . Then you can have some good News soon
Thank you, for being so honest and outlining the 'not so successful' stories. It assists women to be informed of all possible outcomes...
you probably dont care but does anybody know of a tool to log back into an Instagram account..?
I stupidly forgot the account password. I would appreciate any tricks you can offer me!
Glad you told us this. You saved me a second process of ufe. I wish I was in the states I would come to you to get my procedure done
I had ufe and the main fibroids didn’t shrink . They get inflamed a lot and I have heavy cramping and pressure. I’m real sad it didn’t work for me
What type of fibroids did you have? What it was the measurement of the main one?
After 1 year of UFE today doctor tell that my 11cm intramural fibroid is still but didn't shrink ..
Why wouldn't you cut off the ovarian branches during the first embolization procedure (assuming the woman does not ever wish to become pregnant), thereby deriving results from the first procedure and also preventing the necessity of a second embolization procedure?
If a woman is not interested in future fertility and we see that ovarian arterial branches are supplying fibroids, we will embolize them. Sometimes these branches are not seen at the time of the procedure, but at the 3 month follow up any enhancement of the fibroids are presumed to be due to ovarian supply (i.e. since we know we cut off the uterine supply already).
@@Atlii Will cutting of the overian branches cause a woman to go into early menopause?
@@xochitlcuevas96 Surprisingly, not what we've seen. However, we won't embolize any ovarian branches that are feeding the fibroids in anyone that has a possible or definite interest in fertility anyway just to be sure.
Seems like no blood supply to the ovaries means they die or barely function, thus sending the woman into menopause. Whether she wants kids or not, seems to be the same result--she might as well as have had a hysterectomy. Crazy.
@@maxsanemitchell1609 Once the uterus is removed, the bladder and bowel drop and the vagina is displaced. That is why hysterectomy can lead to bladder and bowel dysfunction, prolapse, and incontinence as well as a 4-fold increased risk of pelvic organ fistula surgery.
I have literally been in a living hell since I had mine done in January 2023 as I had a 13 cm fibroid not a candidate but the doctor thought he could help me. I have been in bed for a year. I do not recommend the surgery to menopausal or perimenopausal, as well as no one confirmed, even with bloodwork.
Please, can you tell us more of your opinion. And what happened to you😢. All the story. Here i am in such troubles and don t know what kind of operation to choose!.
Im really torn..my biggest concern is conceiving and giving birth to a healthy baby..does this surgery only cut off blood supply to the fibroid? What happends whn thr fibroid die..do we still need those cut off blood supply for anything else?
Was my UFE a failure? I had 20 fibroids , one a very large pendunculated fibroid.
I was very ill straight after the procedure very low blood pressure sweating profusely I came round to find the doctor struggling to raise my blood pressure and control my symptoms then and continual sickness for three days. I remained constipated for 14 agonising days. I was admitted for 3 days with an infection about a month later.
Every month from there in during my period I had agonising cramps so severe to push out a tampax and became completely incontinent.
My fibroids calcified and remained large the pedunculated fibroid was agony it remained large on the stalk but had some calcification .
I never regained continence and experienced pain every month in winter months the pain of degrading was horrific.
Today after menopause I can still tell when my period would have been .
W
Does anyone know what if anything went wrong. I can't believe this was a success. Went round and round to various gynacology appointments with one rating they were very pleased with the size of the pendunculated fibroid which had hardly changed.
To be honest I'm pleased that they have suggested I go elsewhere.
What went wrong.
Dr Lipman once the fibroids are dead, do the expell from the body?
Only rarely.
I've been wondering about that. I'm so glad someone asked!
I guess if it doesn’t get expel from the body, then your stomach will still be bloated like you’re pregnant.
I heard in some cases you can get a Hysteroscopy or even a Myomcetomy to remove the fibroids.
Aftar avm embolization my leg can not work properly not have any feeling in my leg pls help me
Does cutting off the supply from the ovarian branches push you into menopause?
Not typically.
But occasionally, yes?
If most of your uterus is covered in intramural fibroids and blood supply is cut off to the fibroids though UFE, does that mean that the uterus itself won't have an mood flow in that area which could kill the uterus? Also, if a woman gets pregnant after UFE can the beads left in affect blood flow to the uterus and placenta?
Uterus completely normal blood flow and alive after UFE. Pregnancies after UFE usually full term and vaginal whereas after myomectomy if get pregnant has to deliver by c- section.
Are there any risk in having dead fibroids in the womb.especially multiple
Thank you explaining that...
Thanks for the information, i am 39 years old, i have done my UFE last month i have one fibroid with 6cm long, i got my second period after ufe now, my bleeding is very heavy and its heavier than pre UFE, will this heavy flow means my UFE failed? Or will i get better ? Pls. Answer 🙏🏼
I'm 39 as well and had mine 3 weeks ago. I just got my first period and I'm cramping like crazy. I hope this doesn't mean anything. But it wasn't this bad b4. 😕
Great video, very informative!
I’m 5mo out of UFE but my Radiologist never had me do an MRI and as of the last 6 weeks I’ve been dealing with two different UTI’s and BV and my pelvic area, especially where the largest fibroid (12cm) was located is hurting, especially if I exercise. Getting an MRI next week and FINALLY seeing an ONGYN tomorrow and have been so scared of worse diagnoses. Does this sound familiar?
Hi, how It went?
What is the cost associated with the second ufe treatment if needed
Dr Lipman how long does bloating last after the UFE procedure?
OK since you only get a 30% reduction in fibroid size and the fibroids do not leave your body, but stays in there, they just shrink and become soft. I think there’s still some bloating unlike a myomectomy, your belly just becomes flat after two weeks because the fibroids are physically removed.
I've had an UFE at 46, 6 months ago in April. Have been having colon cramp/pain for 3 months straight and started excessively bleeding with large blood clots from june 1st till now. I've had heavy bleeding before in my life, but not for the last 6 years and never as much as this. I'm very low on hb and iron and it's hard to function. But ultrasounds show that fibroids are shrinking. Also i'm experiencing menopausal symptoms that i help relieve with estradiol patches and progesterone pills.
Now my doctor wants to discuss having a hysterectomy to stop my bleeding. I don't understand why this is happening! Has my UFE failed? What are my options?
Did you ever follow up with the Interventional Radiologist that performed your UFE? If not, that would be the first thing I would recommend. Ultrasounds are of no use after UFE. You need a pelvic MRI with and without iv contrast. We need to know if all of the fibroids are dead or not. That is the only imaging study that can tell you that. Good luck.
Where did you have your procedure done? I’m sorry to hear you’re going through some difficult time after the procedure. Please let us know if you have reached resolution yet.
Hello there, hope you are better now.
Is there ever a size that’s too big for the UFE procedure? Especially due to the pain that occurs afterwards?
Pain not based on size of fibroids. Need to go to experienced Interventional Radiologist to minimize post-procedural pain.
I hear more that UFE is ineffective and that the fibroids always grow back. Also more than before. Why isn’t this mainstream of it is so effective. Doctors always go to some type of “ectomy” procedure.
Whatever you’re hearing is not based on medical facts. The success rate for UFE is 90%. They dont typically grow back because it typically knocks out all of the fibroids. Therefore, if you’re embolized in your forties, you dont typically need anything else done because before you could grow new fibroids, you’d be in menopause. Learn more at ATLii.com
This happened to me. What do you recommend as an option for someone who is interested in fertility?
I’m scheduled to have a Pelvic MRI July 2nd now that I’m learning about UFE, I’m confused about having that procedure or just have an hysterectomy.. I really wanted to avoid hysterectomy since I will be going in menopause soon but the bleeding and pain is getting worse more hostile every month. Definitely confused.
I would strongly encourage you to avoid hysterectomy. While it does end the bleeding it comes with negative side effects beyond the obvious surgical risks. It can change women psychologically (like a man being castrated). It can cause sexual dysfunction (exs. loss of libido, loss of orgasm), urinary leaking requiring diapers, and bone loss just to name a few. UFE has a very high success rate, you avoid the risks/long recovery of surgery, and you get to keep your uterus ! Good luck to you.
@@Atlii thank you replying ❤️
Hello dr I am 23 year is I am a good candidate of ufe is it has any effect on my fertility or causing difficulty in getting pregnant
Hello Dr. Lipman. I am 2 months post op UFE. First cycle was tolerable. Second cycle after day 2, I’m noticing tiny clots, does this means my procedure failed ? seeing my IR for follow end of this month, just very nervous. Thanks
No, it doesn't. Getting a pelvic MRI with and without IV contrast just prior to seeing your IR will be very important. Good luck.
Hello ! Please guide me , i have two queries ! One : what are chances of any emboli toward lungs or brain ? Second : if a person age 46yr have ovarian cysts (simple or hemorrhagic cysts) and uterine fibroids ,is she good candidate for UFE or hystrectomy ?
If you undergo UFE from the standard right groin approach there is absolutely no chance of emboli to the lungs or brain. Ovarian cysts can cause pain in some women, but they go away on their own without treatment in almost every single patient. Almost 100% of patients that were told they would be a candidate for surgery are also a candidate for UFE, but you need to hear that from an Interventional Radiologist (and NOT your Gynecologist). Learn more at ATLii.com
What if there is suspection of one ovarian cyst becomes hemmorrhgic and gynaecologist recommend complete hystrectomy while intervention radiolgist asked to remove ovarian cyst via laproscpic and for fibroid go for UFE , we are confused ,how do we proceed.
@@Atlii you said no chance of emboli if done in the groin, what are the chances if done via radial artery? I am scheduled in 2 weeks to have a UFE done via radial artery, I was hoping for it done via the groin but my doctor made it sound like the arm is a better safer option.
@@angelakaseman5304 It is absolutely not a safer option. It is also not a better option. There are clotting issues (you'll need a special blood thinning cocktail which you don't need if they went femoral). There is a small stroke risk from radial and clots in the forearm and hand which are under reported since they typically don't cause any significant injury but might be an issue in the future. I have had multiple "radialists" convert to femoral approach when they visited my Center and saw me perform a UFE from femoral approach. It can obviously be done from either approach, but it is no question safer from a femoral approach. Good luck to you.
@@Atlii Thank you for your quick response to my question. I will address this with my doctor here in Houston, TX. Dr Fox. I hope that he will listen to my concerns because I don't want to have to reschedule this procedure but the less risk the better.
Will the patient go into menopause after this procedure?
Not if you’re less than 40 years of age
Is this procedure safe for cardiac patients with an ICD?
The UFE procedure is safe for patients with an ICD. However, a MRI can not be done with ICD patients. If there is a high quality ultrasound you can qualify for UFE (instead of an MRI which is typically required). Learn more at ATLii.com
Hi doc, iam planning to do UFE and 46 yrs old with 2 intramural and 3 posterior around 6 and 8 cm.
I read several articles which said that women over the age of 45 only shrink by 50%. Will the remaining 60% of the fibroid remain solid like a lemon or become soften
Also is it safer to do it from groin or wrist?Thank you
Groin is much safer. No patient benefit doing UFE from wrist. UFE is not about shrinkage, its about symptom improvement. Usually you get a lot of both. Whats left after UFE shouldnt ever bother you again ( like fibroids that go through menopause). Good luck !
Even if you aren’t concerned w fertility you might not want UFE because it can affect the ovaries and your hormones and put you into menopause earlier
That’s not true ! There are many studies showing no effect on ovarian function in anyone under 40 years of age. The chance of succesful pregnancy is every bit as likely with UFE as myomectomy. However, where UFE is way better as births post-UFE are typically full term and vaginal whereas with myomectomy they wont let you have a vaginal birth you’ll get a c-section. Also, UFE treats ALL of the fibroids whereas myomectomy never does so myomectomy patients often recur within 5 years (11% per year!). Please get your facts straight !
@@Atlii OK but what about women over 40, who make up a majority of people seeking fibroid treatments? They deserve to know that many studies show that ovaries can be affected by UFE, and that it can hasten menopause. Fibroids can recurr in any uterus-sparing proceure, including UFE.
@@pseudonamed For women 40-45, it’s 1-2%. This is much lower than the conversion rate in myomectomy patients to hysterectomy intraoperatively which also ends fertility. Every myomectomy patient is made aware that they might wake up without their uterus. Why dont you mention that?
Is it possible to have UFE when the fibroid (1 fibroid ) is outside the uterus and is about 10cm or 15cm ?
Likely yes.
Hello Dr. Lipman, I have a question please. If a woman has had a history of blood clotting due to covid (right leg DVT) are they a good candidate for a UFE?
A right leg DVT would not disqualify you from having UFE.
Did u cut both the RT. and LT. uterine arteries?
Most embolizations involve both the uterine arteries. In unusual cases where all of the blood supply to the fibroids is coming from only one artery, only one needs to be embolized.
@@Atlii I only had one artery that the radiologist could locate, I wonder if the procedure will still be effective....
@@narcee1550 Some women only have one (and rarely none) uterine artery. With one uterine artery sometimes embolizing the one is all that is necessary. Other times, the ipsilateral (same side) ovarian artery needs to be embolized (if a woman is not interested in fertility) to achieve a successful embolization. Learn more at ATLii.com
@@Atlii Thank you so much for responding!! How kind of you to answer the questions of people from all over the world! The radiologist blocked the one artery and was searching for the other. He seemed to be perplexed at not locating the other. Anyway, I'm passed childbearing years but didn't want the big surgery. Prayerfully I will get the benefit that this procedure was designed for. Once again thanks for responding! You've been helpful!
I had UFE and 6 months later it stayed 11.5cm
Did they plug up the wrong vein? I have a feeling he wasn't experienced enough...
Did you get a follow up MRI with contrast with your Interventional Radiologist to see if the fibroids are infarcted?
@Atlii I called my original doctor and he told me to get mri, and the sonogrammer lady said it's 11.5cm, when the doctor called me 2 weeks later he was act able to read the results better and said my fibroid is actually 13.5cm and there is a cyst as well. I didn't talk to the inter radiologist about it. My doctor said go do research and he will he do another referral for me. I felt maybe mine was way too big for UFE, not sure why they let me do it in the first place, now I'm wondering if I should have it REVERSED, in case of the potential early menopause.
How effective is UFE for intramural fibroids? I'm 46, what are chances it will cause me to go into menopause?
Very effective (90%). You have ~5% chance of going in to menopause after UFE at age 46. You have ~33% chance of going in to menopause after a hysterectomy where they don't take out the ovaries.
@@Atlii Thanks for the advice. What is the chance of a fibroid becoming cancerous after menopause if they are not treated perimenopause?
If the UFE is performed at the age of 46 to shrink fibroids, and HRT is commenced at 51 for menopause hypothetically, will the fibroids grow again due to oestrogen?
If you undergo UFE at 46 and all of the fibroids are shown to be dead on the 3 month follow up MRI, it doesn't matter how much exogenous estrogen you take after that. Dead fibroids remain dead.
@@Atlii I have fibroids which is causing heavy bleeding and it’s effecting my Hemoglobin I want to go for UFE as we know now that it stops the blood supply to fibroids causing it to shrink n die in rare occasions one can experience fibroid explosion which I think means u expel the fibroids anyways my question is since ufe shrinks n kills the fibroid but it still remains where it is I want to know if I decide to not to have the dead fibroids in my system/ uterus can I go for Myomectomy to just get rid of dead fibroids I mean one can go for Myomectomy after Ufe if one want what would you say regarding this please let me/us know thank you .
@@shaimaya1117 After UFE, the fibroids die. They then start to soften and shrink. The death of the fibroids is a sterile death just like what happens with menopause. No one that goes in to menopause undergoes a myomectomy to remove those dead fibroids. However, in rare instances, a fibroid will try to expel and that may need to be removed from the inside (i.e. hysteroscopic myomectomy) similar to a D & C procedure.
@@Atlii oh ok thank you