- UAE is a minimally invasive radiological procedure that shrinks fibroids by blocking their blood supply.
- Myomectomy is a surgical procedure that removes fibroids while leaving the uterus intact.
- Myomectomy is the preferred option for women who wish to retain their fertility.
- Recovery is generally faster with UAE, but myomectomy offers a more definitive removal of the fibroids.
- The choice depends heavily on your symptoms, fibroid characteristics, and future pregnancy plans.
What is Uterine Artery Embolisation (UAE)?
Uterine Artery Embolisation, sometimes called Uterine Fibroid Embolisation (UFE), is a minimally invasive procedure performed by an interventional radiologist, not a surgeon. The goal isn't to remove the fibroids, but to cut off their blood supply, causing them to shrink and die over time.
During the procedure, tiny particles are injected into the arteries that feed the fibroids. This blocks the blood flow, leading to a significant reduction in fibroid size and a great improvement in symptoms like heavy bleeding and pressure. For many women in the UK, the appeal of a less invasive procedure is high, especially given the potential for a quicker recovery.
Myomectomy: The Surgical Approach to Fibroid Removal
A myomectomy is a surgical operation specifically designed to remove fibroids while preserving the uterus. This is the key difference from a hysterectomy. It can be performed in several ways: open, laparoscopic, or robotic-assisted, depending on the size, number, and location of your fibroids.
The primary advantage of myomectomy is that the fibroids are physically removed from the body, providing immediate relief from the bulk and pressure symptoms. It is considered the gold standard for women who have fibroid-related symptoms and wish to become pregnant in the future.
Key Differences: Recovery, Fertility and Recurrence
The choice between UAE and myomectomy often comes down to your personal circumstances. Recovery from UAE is generally faster, with most women back to normal activities within a couple of weeks. Myomectomy recovery varies from 2-6 weeks, depending on the surgical method used.
For fertility, the evidence strongly supports myomectomy as the preferred option. The Royal College of Obstetricians and Gynaecologists (RCOG) recommends myomectomy for women wishing to conceive, as UAE can sometimes impact ovarian function and the uterine wall. While fibroids can recur after either procedure, myomectomy provides a longer interval before any potential regrowth causes symptoms again.
Frequently asked questions
Is UAE or myomectomy better for heavy bleeding?
Both procedures are very effective at reducing heavy menstrual bleeding caused by fibroids. UAE shrinks the fibroids, which in turn reduces bleeding, while myomectomy removes the source of the bleeding entirely. The best choice depends on other factors like your desire for future pregnancy.
Can I get pregnant after UAE?
Pregnancy is possible after UAE, but it is not the recommended treatment for women who are actively trying to conceive. Myomectomy is the standard of care as it preserves the uterus and its blood supply in a more predictable way.
What are the main risks of UAE?
The main risks, though uncommon, include infection, bleeding, and potential damage to the uterine wall. A small number of women may experience premature menopause if the blood supply to the ovaries is unintentionally affected.
How do I decide which procedure is right for me?
The decision should be made after a thorough discussion with a gynaecologist who can assess your fibroids with imaging (like an MRI), understand your symptoms, and talk through your future family plans. It's a very personal decision with no single 'best' answer for everyone.
Could a doctor-led plan help you?
A 30-minute video consultation with Dr Berra Önsoy — reviewing your imaging and giving you a clear personalised plan for uterus-sparing fibroid surgery.
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