Uterine artery embolization for symptomatic uterine myomas

Objective: To evaluate the role of uterine artery embolization as treatment for symptomatic uterine myomas. Design: Medline literature review, cross-reference of published data. and review of selected meeting abstracts. Result(s): Results from clinical series have shown a consistent short-term reduction in uterine size, subjective improvement in uterine bleeding, and reduced pain following treatment. Posttreatment hospitalization and recovery tend to be shorter after uterine artery embolization compared with hysterectomy. Randomized controlled trials have not been conducted, and long-term efficacy has not been studied. A limited number of deliveries have been reported following uterine artery embolization for uterine myomas. Conclusion(s): Uterine artery embolization is a unique new treatment for symptomatic uterine myomas. Even without controlled studies, demand for this procedure has increased rapidly. Uterine artery embolization may be considered an alternative to hysterectomy, or perhaps myomectomy, in well-selected cases. At the present time, however, uterine artery embolization should not be routinely recommended for women who desire future fertility. (Fertil Steril(R) 2000,74:855-69. (C) 2000 by American Society for Reproductive Medicine.)