Uterine fibroid embolization versus myomectomy in women wishing to preserve fertility: preliminary results of a randomized controlled trial

Eur J Obstet Gynecol Reprod Biol. 2006 Jun 1;126(2):226-33. doi: 10.1016/j.ejogrb.2005.10.008. Epub 2005 Nov 15.


Objective: To compare the clinical results of surgical and endovascular treatment of uterine myomas in young women.

Study design: In a university-affiliated, tertiary care center a prospective trial was conducted. Sixty-three women, wishing to retain fertility, with intramural fibroid(s) larger than 4 cm, were randomly selected either for uterine artery embolization or myomectomy. Invasiveness, efficacy, and complications of both procedures were compared.

Results: Thirty embolizations and 33 myomectomies (15 laparoscopic, 18 open) were performed. The mean follow-up was 17 months. In embolized patients, there was a significantly shorter procedure length (p<0.0001), hospital stay (p<0.001) and disability period (p<0.0001), lower CRP (p<0.001) and higher hemoglobin (p<0.0001) concentrations the 2nd day after procedure. But there was a higher incidence of re-interventions (p<0.01) and a lower rate of total symptomatic relief (p<0.1). The groups did not significantly differ in: technical success rate, febrile morbidity, FSH levels 6 months after the procedure, and complication rates.

Conclusions: Although the reproductive outcomes of uterine artery embolization and myomectomy cannot be evaluated at the moment, our first results indicate that both methods are clinically successful in the majority of cases and are not connected with significant number of serious complications.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Czech Republic
  • Embolization, Therapeutic / methods*
  • Female
  • Fertility
  • Gynecologic Surgical Procedures / methods*
  • Humans
  • Laparoscopy / methods
  • Leiomyoma / pathology
  • Leiomyoma / surgery
  • Leiomyoma / therapy*
  • Length of Stay
  • Myometrium / surgery
  • Postoperative Complications
  • Prospective Studies
  • Treatment Outcome
  • Uterine Neoplasms / pathology
  • Uterine Neoplasms / surgery
  • Uterine Neoplasms / therapy*
  • Uterus / blood supply