Uterine Artery Embolization versus Myomectomy for the Treatment of Symptomatic Uterine Fibroids: A Systematic Review

Abstract

Introduction: Uterine fibroids are the most common benign tumors in women, often causing heavy menstrual bleeding and bulk symptoms. This review compares the efficacy and safety of uterine artery embolization (UAE) and myomectomy.

Methods: A systematic search for RCTs and comparative cohort studies was performed. We included studies comparing UAE to either laparoscopic or open myomectomy. Primary outcomes were improvement in quality of life, re-intervention rates, and future fertility.

Results: The analysis of 15 studies showed that both UAE and myomectomy resulted in significant improvements in symptom severity and quality of life. However, myomectomy was associated with lower long-term re-intervention rates. UAE was associated with a shorter hospital stay and faster recovery. Evidence regarding fertility outcomes favored myomectomy.

Discussion: The choice between UAE and myomectomy depends on the patient's primary symptoms and desire for future fertility. Myomectomy remains the preferred option for women wishing to conceive, while UAE is a highly effective, less invasive alternative for others.

Conclusion: Both UAE and myomectomy are effective for treating symptomatic fibroids, but myomectomy offers better durability and is preferred for fertility preservation.