During uterine fibroid embolization (UFE), a doctor blocks the small arteries that feed your fibroids, working from inside the blood vessels. You are usually awake but sedated. A thin tube called a catheter goes in through a tiny puncture in the groin or wrist, and X-ray images guide it to the uterine arteries. Tiny particles are then released to cut off the fibroids' blood supply, on both sides. RadiologyInfo, the patient site of the American College of Radiology and Radiological Society of North America, says UFE is usually complete within 90 minutes.
Here is what typically happens from check-in to recovery. Details vary between doctors and settings, so ask your own doctor how they do each step.
UFE at a glance
| Step | What typically happens |
|---|---|
| 1. Check-in | Gown, vital signs, IV line, consent review |
| 2. Sedation and numbing | Sedative through the IV; local anesthetic at the groin or wrist |
| 3. Access | Tiny skin nick; catheter placed in the femoral (groin) or radial (wrist) artery |
| 4. Mapping | Contrast dye and X-ray images show the uterine arteries |
| 5. Embolization | Particles injected into the left and right uterine arteries until flow to the fibroids slows |
| 6. Closing | Catheter removed; pressure, a closure device or a wrist band |
| 7. Recovery | Monitoring and pain control, then home or an overnight stay |
Before it starts: check-in and IV
You change into a gown and a nurse checks your blood pressure, heart rate and oxygen level. RadiologyInfo says a nurse or technologist places an IV line in your hand or arm, which is used for sedation and other medicines. The team reviews your consent form, allergies and medicines. This is a good time to ask any last questions. If you have not yet read it, our checklist on how to prepare for UFE covers what to bring.
RadiologyInfo says UFE is performed in a catheterization lab, or occasionally an operating room, with X-ray equipment and a screen that shows the blood vessels.
Sedation and numbing
ACOG says a sedative and local anesthesia are given for UFE. RadiologyInfo says that with sedation you should feel relaxed, sleepy and comfortable. This is different from general anesthesia, where you are fully asleep; ask your doctor which type you will have. The doctor then numbs the skin at the groin or wrist. RadiologyInfo notes the numbing medicine may briefly burn or sting.
Some centers add a nerve block during the procedure to reduce pain afterward. In a 2018 randomized trial of 44 women, a superior hypogastric nerve block placed during UFE cut the amount of opioid needed in the recovery room by more than half. Ask whether your doctor uses one. Our article Is UFE painful? covers pain control in detail.
Reaching the uterine arteries: groin or wrist
The doctor makes a tiny nick in the skin and places the catheter into an artery. RadiologyInfo describes the femoral artery in the groin as the usual entry, with the radial artery in the wrist as an alternative. RadiologyInfo says you may feel pressure when the catheter goes in.
Both routes work. In a 2021 randomized trial of 153 women at three hospitals, wrist access had the same efficacy and safety as groin access. Major complications were 0% with the wrist and 2.7% with the groin, a difference that was not statistically significant. The wrist group had less radiation and rated their comfort during the procedure higher. Your doctor will choose based on your arteries and their own experience.
Questions about your treatment options? Dr. Fox can help.
Book a ConsultationThis article is part of our Fibroid Treatment Guide.
Mapping and blocking the blood supply
Once the catheter is in place, the doctor injects X-ray contrast dye to see the arteries on the screen. RadiologyInfo says the contrast may make you feel warm for a few moments. The catheter is steered into the uterine artery on one side.
The doctor then injects embolic particles. RadiologyInfo gives polyvinyl alcohol (PVA) particles, which resemble coarse sand, as an example; another type, round microspheres, is also used. The particles flow toward the fibroids, which have a rich blood supply, and lodge in the small vessels. The doctor watches on the screen and stops once the flow is slowed enough. The same is done on the other side. RadiologyInfo describes injecting particles until the vessels on both sides are blocked.
In a 2021 randomized trial of 54 women comparing PVA particles with microspheres, pain scores and pain medicine use in the first 24 hours were similar, though more women in the PVA group needed an extra rescue pain medicine.
Over the following days and weeks, the fibroid tissue that lost its blood supply breaks down and shrinks.
Closing up
When both sides are treated, the catheter is removed. RadiologyInfo says the doctor applies pressure to stop any bleeding and sometimes uses a closure device to seal the small hole in the artery. With wrist access, a compression band may be placed around the wrist for a while. There are typically no stitches.
How long the hands-on part takes varies. RadiologyInfo says UFE is usually complete within 90 minutes. In the 2021 trial above, the embolization step itself averaged about 32 minutes through the wrist and 39 minutes through the groin.
In the recovery area
Cramping usually begins soon after the procedure, as the fibroids lose their blood supply. Nurses check your vital signs and the puncture site and give pain and anti-nausea medicine. ACOG says you may need to lie flat for a few hours.
ACOG says some women go home the same day and others stay overnight. In a 2021 series of 374 same-day UFEs done through the wrist, the median time in recovery was about 3.7 hours, and 2.1% were kept overnight. You will need someone to drive you home. The first days at home are covered in our UFE recovery timeline.
Who does the procedure
RadiologyInfo and ACOG describe UFE as usually performed by an interventional radiologist. Vascular surgeons, who are trained in catheter work inside arteries, also perform it. A 2018 report from an academic center described a vascular surgery-based UFE program of 26 procedures with 100% technical success. Whoever does your procedure, ask how often they perform UFE and how they handle follow-up. Our article on who performs UFE explains the training involved.
Because UFE uses X-ray guidance, you receive some radiation. In the 2021 trial above, radiation dose was lower with wrist access. If radiation is a concern for you, ask your doctor how they keep the dose low.
Is it safe?
Serious problems during the procedure are uncommon. The CIRSE 2015 guideline reports technical success in 95 to 97% of cases and major complications in up to 5% during the procedure and the first month. Deaths are extremely rare. During the procedure, tell the team right away if you feel chest pain, trouble breathing, itching or hives, or severe pain at the puncture site. For more on how UFE compares with surgery and other options, see our fibroid treatment guide.
Frequently Asked Questions
Am I awake during UFE?
Usually you are awake but sedated. ACOG says a sedative and local anesthetic are given, and RadiologyInfo says sedation should leave you feeling relaxed, sleepy and comfortable. Ask your doctor which type of sedation they use.
How long does UFE take?
RadiologyInfo says UFE is usually complete within 90 minutes. Time spent checking in beforehand and recovering afterward adds several hours to the day.
Is UFE done through the groin or the wrist?
Either can be used. In a randomized trial of 153 women, wrist access was as safe and effective as groin access, with less radiation and better comfort during the procedure. The choice depends on your anatomy and your doctor's approach.
Are there stitches after UFE?
Usually not. The puncture is tiny, and the doctor closes it with pressure, a closure device or, for the wrist, a compression band.
Is there an incision?
Only a tiny nick in the skin where the catheter goes in. The uterus is not cut and nothing is removed.
Keep Reading
- Uterine Fibroid Embolization (UFE) in New York City
- How to Prepare for UFE: Your Checklist From Consultation to Procedure Day
- Is UFE Painful? What the Pain Feels Like and How It Is Controlled
- UFE Recovery Day by Day: What to Expect Week by Week
- Who Performs Uterine Fibroid Embolization? Interventional Radiologists, Vascular Surgeons and the Team
- UFE Risks and Complications: What the Numbers Show
- Fibroid Treatment Guide: every option, compared
Sources
- RadiologyInfo.org (ACR/RSNA) — Uterine Fibroid Embolization
- American College of Obstetricians and Gynecologists, FAQ522 — Uterine Artery Embolization (last reviewed May 2026)
- Khayrutdinov et al., Diagn Interv Radiol, 2021 — randomized comparison of wrist (radial) vs groin (femoral) access for UAE (153 women)
- Han et al., Radiology, 2021 — randomized trial of PVA particles vs microspheres and pain after UAE (54 women)
- AJR, 2021 — outcomes of 374 same-day transradial uterine artery embolizations
- Yoon et al., Radiology, 2018 — superior hypogastric nerve block for pain after UAE, randomized sham-controlled trial (44 women)
- van Overhagen & Reekers, Cardiovasc Intervent Radiol, 2015 — CIRSE standards of practice for uterine artery embolization
- Nassiri et al., Ann Vasc Surg, 2018 — a vascular surgery-based uterine artery embolization program (26 procedures)
Medically reviewed by David Fox, MD, FACS, RPVI. This article is general information, not a substitute for a medical evaluation.
Living with heavy periods, pelvic pressure or other fibroid symptoms? Schedule a consultation with Dr. David Fox at Fox Vein & Vascular in Manhattan to find out whether uterine fibroid embolization is right for you. Call (212) 362-3470 or request a UFE consultation online.
