If you are one of the millions of women who suffer from uterine fibroids, you may be interested in learning about fibroid expulsion. This is a natural process that can occur after having uterine fibroid embolization (UFE), a procedure that is used to treat fibroids. In this blog post, we will define what fibroid expulsion is and explain what happens during and after UFE. We will also list the symptoms of this process so that you can be aware of them if they occur. Finally, we will discuss the causes of fibroid expulsion and how UFE can lead to it.
What is fibroid expulsion?
Fibroid expulsion occurs when the body expels a fibroid through the vagina. This can happen after uterine fibroid embolization (UFE), especially when the fibroid lies just beneath or inside the lining of the uterus. Studies report fibroid expulsion after about 5% to 16% of UFE procedures, depending on how it is defined. Fibroid expulsion is most likely to occur within the first few months after UFE, but it can occur any time from weeks to years afterwards. While most cases of fibroid expulsion tend to happen within a year of UFE, later cases have been reported.
What happens during fibroid expulsion?
During fibroid expulsion, the fibroid is slowly pushed out through the vagina. This can happen over a period of days or weeks. The fibroid may be expelled in one piece or in several pieces. You may notice that the expelled fibroid looks different from when it was inside your uterus – it may be smaller or have a different shape. In some cases, fibroid tissue may still be attached to the uterine wall. In these cases, tissue may collect around the cervix but not enter the vagina. Eventually, this tissue may need to be manually removed by your doctor.
What are the symptoms of fibroid expulsion?
The most common symptoms of fibroid expulsion are vaginal discharge and bleeding from the vagina. Bleeding can range from light spotting to heavy bleeding. Other symptoms may include cramping, pain in the lower abdomen or back, pelvic pressure, fever, or passing tissue. If you experience any of these symptoms, especially fever and/or foul-smelling discharge, it is important to contact your doctor as this could indicate a possible infection.
What are the causes of fibroid expulsion?
The most common cause of fibroid expulsion is uterine fibroid embolization (UFE). UFE is a minimally invasive procedure that is used to treat fibroids. It involves injecting small particles into the blood vessels that supply the fibroids. This cuts off the blood supply to the fibroids and causes them to shrink. In some cases, this can lead to expulsion of the fibroid through the vagina.
Fibroid expulsion can also occur after undergoing a high-intensity ultrasound. Focused ultrasound procedures use high-frequency sound waves to target and destroy the fibroids. While this is an effective treatment for fibroids, it can also lead to expulsion of the fibroid through the vagina.
Finally, fibroid expulsion can occur spontaneously without any underlying cause. This is rare, but it has been documented in a small number of cases.
Treatment for Fibroid Expulsion
Treatment is not always needed for fibroid expulsion, however sometimes it can be necessary. For example, if an infection is present, it will need to be treated with antibiotics to prevent the infection from spreading. Some women need a procedure to remove remaining fibroid tissue through the vagina or with a hysteroscope, and in uncommon cases, particularly with severe infection, a hysterectomy may be needed. Contact your doctor promptly if you have fever, foul-smelling discharge, or heavy bleeding.
In Conclusion
In this blog post, we have discussed fibroid expulsion, what happens during this process, and listed the symptoms that you may experience. We have also discussed the potential causes of fibroid expulsion and how UFE can lead to it specifically. Finally, we have briefly outlined treatment options for those who do experience fibroid expulsion. If you have any further questions about UFE or fibroid expulsion, please contact your doctor.
Sources
- Quality improvement guidelines for uterine artery embolization for symptomatic leiomyomata. Society of Interventional Radiology / Journal of Vascular and Interventional Radiology, 2014.
- Outcomes following fibroid expulsion after uterine artery embolization. Journal of Vascular and Interventional Radiology, 2011.
- Predictors and Clinical Outcomes of Fibroid Expulsion After Uterine Artery Embolization. CardioVascular and Interventional Radiology, 2023.
- Fibroid Expulsion after Uterine Artery Embolization. Seminars in Interventional Radiology, 2019.
- Myoma expulsion after minimally invasive therapeutic strategies: a systematic review. European Journal of Obstetrics & Gynecology and Reproductive Biology, 2025.