|April 2003 · Vol. 15, No. 4
Uterine artery embolization for symptomatic fibroids: Pros and cons
This procedure—less invasive than hysterectomy or myomectomy—is becoming increasingly popular among patients. Here, a look at the state of the art.
Dr. Goldberg is clinical assistant professor, department of obstetrics and gynecology; Dr. Pereira is a fellow, maternal-fetal medicine; and Ms. Mude-Nochumson is a second-year medical student, Jefferson Medical College,
Uterine artery embolization (UAE) may be especially useful in women who are poor surgical candidates or have extensive adhesive disease, or who refuse blood products or are perimenopausal.
The average reported symptom improvement is 87%; the mean reduction in fibroid volume is 46%.
Most patients are discharged within 24 hours of the procedure and experience an average recovery period of 8 days.
Women undergoing UAE for fibroids are more likely than those undergoing myomectomy to need further invasive treatment within 3 to 5 years.
Although several series and case reports have noted successful pregnancies following UAE, desire for fertility is considered a relative contraindication by some authorities.
With the increasing demand for nonsurgical alternatives to hysterectomy or myomectomy for fibroids, uterine artery embolization (UAE) has grown in use and popularity—and most patients report a high level of satisfaction after the procedure.
UAE has been shown to be safe and effective in selected patients with symptomatic fibroids unresponsive to medical treatment. If they are not contemplating pregnancy and do not have additional pelvic pathology, these women may elect UAE as an appropriate alternative to hysterectomy or myomectomy. This article reviews the indications, contraindications, technique, complications, and outcomes of UAE.