Uterine Fibroid Embolization

OBJECTIVE To review evidence supporting the use of uterine fibroid embolization (UFE) as an alternative to hysterectomy and myomectomy for managing uterine fibroids.

QUALITY OF EVIDENCE MEDLINE was searched using the MeSH terms embolization, therapeutic; leiomyoma; treatment outcome; pregnancy; and clinical trials. Most published studies on use of UFE for management of uterine fibroids provide level II evidence.

MAIN MESSAGE For 71% to 92% of patients, UFE is effective at alleviating fibroid-related symptoms. After UFE, fibroids are reduced in size by 42% to 83%. Patients’ satisfaction with the procedure is high (>90%), and UFE is safe and has a low rate of major complications (1.25%). When compared with hysterectomy, UFE is associated with fewer major complications, shorter hospital stays, and faster recovery. Although successful pregnancy following UFE is possible, there is insufficient evidence to advocate use of UFE over myomectomy for management of uterine fibroids in women wishing to preserve fertility.

CONCLUSION For treatment of symptomatic uterine fibroids, UFE is a safe and effective nonsurgical alternative to hysterectomy and myomectomy.