What does this research mean for the field?

Minimally invasive and pharmacological treatments are effective alternatives to traditional surgery for uterine fibroids in appropriately selected patients, though management must be individualized based on patient characteristics and reproductive goals. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The review aims to evaluate contemporary management strategies for uterine fibroids, emphasizing individualized approaches.

June 17, 2026Open Access

Contemporary Management of Uterine Fibroids

Key Points

The review aims to evaluate contemporary management strategies for uterine fibroids, emphasizing individualized approaches.
Comprehensive search of PubMed/MEDLINE, Scopus, and Web of Science for studies from January 2010 to December 2025.
Included clinical trials, systematic reviews, and meta-analyses on treatments for uterine fibroids in adult women.
Prepared according to the SANRA recommendations for quality reporting.
Included 97 studies in qualitative synthesis.
Minimally invasive techniques showed high efficacy in symptom control and better quality of life with fewer complications than surgery.
Pharmacological therapies effectively reduced bleeding and fibroid volume, although long-term use is limited by side effects.

Abstract

Background: Uterine fibroids (leiomyomas) are the most common benign tumors in women of reproductive age and represent a significant cause of abnormal uterine bleeding, pelvic pain, infertility, and reduced quality of life. Contemporary management has evolved toward individualized, uterus-sparing approaches, incorporating pharmacological and minimally invasive strategies alongside traditional surgical methods. Methods: This narrative review was conducted based on a comprehensive search of PubMed/MEDLINE, Scopus, and Web of Science databases for studies published between January 2010 and December 2025. The search strategy combined Medical Subject Headings (MeSH) and free-text terms related to uterine fibroids and their management. Eligible studies included clinical trials, systematic reviews, and meta-analyses focusing on pharmacological, minimally invasive, and surgical treatments in adult women. The review was prepared in accordance with the Scale for the Assessment of Narrative Review Articles (SANRA) recommendations to improve methodological transparency and quality of reporting. Results: A total of 97 studies were included in the qualitative synthesis. Minimally invasive techniques, including uterine artery embolization (UAE), radiofrequency ablation (RFA), and high-intensity focused ultrasound (HIFU), demonstrate high efficacy in symptom control and improvement of quality of life, with shorter recovery times and lower complication rates compared to conventional surgery. However, their impact on fertility remains variable and requires careful patient selection. Pharmacological therapies, particularly GnRH analogues and antagonists, effectively reduce bleeding and fibroid volume, although their long-term use is limited by side effects. Conclusions: The management of uterine fibroids should be individualized, taking into account symptom severity, fibroid characteristics, patient age, and reproductive plans. Minimally invasive and pharmacological treatments represent effective alternatives to surgery in appropriately selected patients, while surgical approaches remain essential in advanced or refractory cases. Future research should focus on optimizing personalized treatment strategies and evaluating long-term outcomes, particularly regarding fertility and recurrence.

Contemporary Management of Uterine Fibroids

Key Points

Abstract

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