Myomectomy vs uterine artery embolisation

Myomectomy removes fibroids while preserving the uterus, whereas uterine artery embolisation reduces fibroid blood flow so the fibroids shrink.

Fibroids are non-cancerous growths in or around the uterus that can cause heavy bleeding, pressure, pain or fertility concerns. Myomectomy removes selected fibroids through an operation while leaving the uterus in place. Uterine artery embolisation uses a catheter to block blood flow to fibroids, allowing them to shrink. Fibroid number, size, position and pregnancy plans shape the discussion.

Myomectomy may be preferred when one or more accessible fibroids are clearly responsible for symptoms, when the uterine cavity needs to be restored, or when future pregnancy is a central goal. The surgical route depends on fibroid location and size. Recovery and any advice about pregnancy after surgery should be discussed before scheduling.

Embolisation may appeal when you want a less invasive approach, have multiple fibroids, or need treatment without removing each growth individually. It can reduce bleeding and pressure as the fibroids shrink. Discuss future pregnancy carefully, because the effect on fertility and pregnancy planning is different from that of myomectomy.

Myomectomy can involve bleeding, infection, scar tissue, injury to nearby organs and fibroid recurrence. Embolisation commonly causes a period of pelvic pain, cramping, nausea or tiredness and can involve infection, reduced blood flow to nearby tissue or an unplanned procedure. Seek urgent help for severe pain, heavy bleeding, fever, faintness or a foul-smelling discharge.

Treatment may need to pause if symptoms are caused by another condition, if anaemia or another health issue needs attention first, or if imaging does not define the fibroids clearly. Medicines, observation, hysteroscopic treatment or another specialist opinion may be discussed. New severe pain or rapidly worsening bleeding needs prompt assessment.

The team reviews symptoms, blood tests, imaging, fibroid position, uterine-cavity involvement, previous operations, general health and reproductive plans. Ask whether treatment aims to improve bleeding, pressure, fertility or several problems together. Also ask about the route, recovery, effect on future pregnancy, need for follow-up and what happens if symptoms return.