Uterine artery embolization for fibroids: a review of current outcomes

Since its introduction in 1995, uterine artery embolization (UAE) for fibroids has been extensively investigated. Particularly in the last 3 to 4 years, several high-quality studies assessing its outcome have been completed. Randomized trials and long-term observational studies have demonstrated that when successful, UAE can provide symptom control similar to that obtained after surgery. Although hysterectomy remains more effective in symptom control and durability, many women are seeking uterine-sparing alternatives. UAE has emerged as the leading minimally invasive treatment for fibroids: Morbidity is low and recovery rapid; serious complications are quite rare. With a few anatomical exceptions, UAE is appropriate for most patients with symptomatic fibroids who have completed childbearing. Although pregnancy is certainly possible after embolization, existing data suggest better reproductive outcomes for myomectomy in the first 2 years after treatment. The current recommendation is for myomectomy as a first choice for patients seeking to become pregnant.