ABSTRACT
Since its introduction in 1995, uterine artery embolization (UAE) for fibroids has
been extensively investigated. Particularly in the last 3 to 4 years, several high-quality
studies assessing its outcome have been completed. Randomized trials and long-term
observational studies have demonstrated that when successful, UAE can provide symptom
control similar to that obtained after surgery. Although hysterectomy remains more
effective in symptom control and durability, many women are seeking uterine-sparing
alternatives. UAE has emerged as the leading minimally invasive treatment for fibroids:
Morbidity is low and recovery rapid; serious complications are quite rare. With a
few anatomical exceptions, UAE is appropriate for most patients with symptomatic fibroids
who have completed childbearing. Although pregnancy is certainly possible after embolization,
existing data suggest better reproductive outcomes for myomectomy in the first 2 years
after treatment. The current recommendation is for myomectomy as a first choice for
patients seeking to become pregnant.
KEYWORDS
Leiomyomas - uterine artery embolization - outcomes
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James B SpiesM.D. M.P.H.
Department of Radiology, CG 201, 3800 Reservoir Rd. NW
Washington, DC 20007-2113
eMail: spiesj@gunet.georgetown.edu