Uterine-Artery Embolization or Myomectomy for Uterine Fibroids

This multicenter randomized trial compared uterine artery embolization (UAE) and myomectomy in 254 women with symptomatic uterine fibroids who wished to avoid hysterectomy. At 2 years, myomectomy was associated with a significantly better fibroid-related quality of life (mean adjusted difference: 8.0 points on the UFS-QOL scale; 95% CI, 1.8–14.1; P=0.01) compared to UAE. Both procedures showed low complication rates (29% for myomectomy vs. 24% for UAE), but UAE required more additional interventions (16% vs. 7%). Menstrual bleeding scores were similar, but myomectomy had longer hospital stays (median 4 vs. 2 days). Pregnancy rates were low in both groups (8% UAE vs. 4% myomectomy). The trial supports myomectomy as superior for quality-of-life improvement, though UAE remains a viable minimally invasive option.

This multicenter randomized trial compared uterine artery embolization (UAE) and myomectomy in 254 women with symptomatic uterine fibroids who wished to avoid hysterectomy. At 2 years, myomectomy was associated with a significantly better fibroid-related quality of life (mean adjusted difference: 8.0 points on the UFS-QOL scale; 95% CI, 1.8–14.1; P=0.01) compared to UAE. Both procedures showed low complication rates (29% for myomectomy vs. 24% for UAE), but UAE required more additional interventions (16% vs. 7%). Menstrual bleeding scores were similar, but myomectomy had longer hospital stays (median 4 vs. 2 days). Pregnancy rates were low in both groups (8% UAE vs. 4% myomectomy). The trial supports myomectomy as superior for quality-of-life improvement, though UAE remains a viable minimally invasive option.