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Uterine artery embolization for symptomatic uterine fibroids

Gupta JK, Sinha A, Lumsden M, Hickey M
Published Online: 
15 August 2012

Uterine fibroids (benign tumours) can cause varied symptoms such as heavy bleeding, pain and reduced likelihood of pregnancy. Surgery (hysterectomy or myomectomy) has traditionally been the main treatment option but it carries a risk of complications. Uterine artery embolization (UAE) is a newer treatment option which blocks the blood supply to the womb and thus shrinks the fibroids and reduces their effects. This review of trials found that women who had UAE and women who had surgery were equally likely to be satisfied with their treatment and had similar improvement in their quality of life. However, the UAE group had a significantly shorter hospital stay and a more rapid return to daily activities. With regards to safety, while there were no differences in major complication rates, the percentage of women with minor complications was higher after UAE. Moreover within five years of UAE there was a five times increased risk of needing a surgical intervention. Therefore, it appears that while UAE is a safe option with an earlier initial recovery, it does carry a higher risk of minor complications and need for further surgery later. There is very low level evidence to suggest that fertility outcomes (live birth and pregnancy) may be better after myomectomy than after UAE, but more research is needed in this area.