Uterine artery embolization (UAE) provides lasting symptom improvement in 75% of women with uterine fibroids for up to 10 years after the procedure, with only 19.4% requiring additional treatment within that timeframe, making it an effective alternative to hysterectomy.
- 75% of patients experience significant symptom improvement at least two years after UAE, with benefits lasting up to 10 years
- Low reintervention rate: Only 19.4% of patients required secondary procedures within 10 years, with hysterectomy being the most common at 15.8%
- Younger patients were more likely to need additional intervention, suggesting age is a factor in long-term outcomes
- Uterine fibroids affect over 80% of African American women and 70% of Caucasian women by age 50, costing up to $34.4 billion annually in the U.S.
- UAE advantages: Low complication rates, brief hospitalization, and supports shared decision-making as recommended by the American College of Obstetrics and Gynecology
Uterine artery embolization (UAE) provides durable symptom improvements in 75% of women up to 10 years after the procedure, according to a study published September 3 in Current Problems in Diagnostic Radiology.
A group at Duke University Medical Center in Durham, NC, quantified long-term symptom outcomes and reintervention rates following UAE for uterine fibroids among 175 women, with results adding to growing evidence that the procedure is an effective alternative to hysterectomy.
"While hysterectomy continues to provide the most definitive management, the number of hysterectomies performed annually in the United States has decreased steadily in recent years, corresponding with increasing rates of UAE," noted lead author Alexis Medema, MD, and colleagues.
With an estimated cumulative incidence that exceeds 80% in African Americans and approaches 70% in Caucasians by age 50, symptomatic fibroids are the leading indication for hysterectomy in premenopausal patients and are estimated to cost up to $34.4 billion annually in the United States, the authors noted. While the safety and efficacy of UAE are well established since its advent in 1995, the likelihood of requiring secondary intervention for persistent or relapsing symptoms is less clear, the authors wrote.
To bridge the gap, the researchers surveyed 199 patients with MRI-confirmed symptomatic fibroids who underwent UAE between January 2013 and December 2018, with outcomes data collected in April 2026. The primary endpoint was need for procedural reintervention, including myomectomy, endometrial ablation, and hysterectomy.
Of 175 survey respondents, 132 (75.4%) reported significant symptom improvement at least two years following embolization. Sixty-one patients (33.2%) required additional medical (17.4%) and/or procedural (18.5%) intervention, with hysterectomy the most common subsequent procedure (15.8%). The Kaplan-Meier 10-year cumulative incidence of any secondary procedure was 19.4%, with younger age at embolization significantly associated with reintervention (hazard ratio 0.91; p = 0.003), the researchers reported.
"UAE provides substantial and durable symptom relief for most patients with symptomatic uterine fibroids, with a low periprocedural complication rate and brief hospitalization period," the group wrote.
As the American College of Obstetrics and Gynecology (ACOG) recommends shared decision-making informed by individual patient values and preferences, the long-term outcomes from the study may play a central role in counseling and informed consent prior to UAE, the authors concluded.
The full study is available here.
