[Uterine fibroids-Minimally invasive treatment with embolization]

Uterine fibroids are the most common benign tumors of the female genital tract. In symptomatic women, uterus-preserving treatment strategies are becoming increasingly more important.

Contrast-enhanced magnetic resonance imaging (MRI) is the imaging standard for preprocedural planning. It accurately enables assessment of the number, size, location and vascularity of fibroids while excluding relevant differential diagnoses.

Uterine artery embolization (UAE) is an established minimally invasive uterus-preserving treatment. Recent technical advances include transradial access, optimized angiographic protocols and modern calibrated embolic agents.

Randomized trials demonstrate sustained symptom relief and improved quality of life with a low complication rate. The use of UAE achieves high fibroid devascularization rates but is associated with higher reintervention rates than myomectomy.

The UAE is an evidence-based alternative to surgery in women with symptomatic fibroids seeking uterine preservation. In women wishing to preserve fertility, myomectomy remains the preferred treatment because of the current evidence.

Patient selection should be multidisciplinary. Careful patient selection, preprocedural MRI, standardized embolization techniques, and structured periprocedural management are essential for optimal clinical outcomes.