Role of uterine artery embolization in the treatment of uterine fibroids

Background and aim Uterine leiomyomas represent a major source of gynecological morbidity in women of reproductive age. This investigation was undertaken to assess the clinical outcomes and procedural effectiveness of uterine artery embolization (UAE) as a fertility-preserving, minimally invasive intervention for women presenting with symptomatic fibroids. Patients and methods A prospective cohort of 50 women diagnosed with symptomatic uterine leiomyomata was enrolled between November 2021 and 2023. Each participant completed a comprehensive preprocedural clinical assessment and pelvic MRI. The UAE was performed via bilateral femoral arterial access using calibrated polyvinyl alcohol embolic particles (355–700 μm). Outcomes were evaluated at 3 months through repeat MRI volumetry and standardized symptom scoring. Results The cohort had a mean age of 41.23 years. Heavy menstrual bleeding constituted the predominant indication (74%), with bulk-related pressure complaints in 18% and pelvic pain in 8% of cases. Three-month follow-up demonstrated a statistically significant mean reduction in total uterine volume of 48.9% ( P =0.02) and a 54% contraction of the dominant fibroid ( P =0.005). Symptom improvement was documented in 94.6% of patients with menorrhagia, 88.9% with pressure-related complaints, and 75% with pain. Technical success reached 98%. Conclusion UAE is a safe, technically reliable, and highly effective nonsurgical option for the management of symptomatic uterine fibroids, delivering substantial volumetric reduction and meaningful clinical improvement. These findings support its role as a first-line treatment for appropriately selected women who wish to preserve uterine function.