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Can Fam Physician
Vol. 53, No. 2, February 2007, pp.250 - 256
Copyright © 2007 by The College of Family Physicians of Canada
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Clinical Review

Uterine fibroid embolization

CME update for family physicians

Antony Raikhlin
Student in the Faculty of Medicine at the University of Toronto in Ontario.

Mark Otto Baerlocher, MD
Radiology resident in the University of Toronto Radiology Residency Training Program.

Murray R. Asch, MD FRCPC
Head of Interventional Radiology at Lakeridge Health Corporation in Oshawa, Ont, and is Past President of the Canadian Interventional Radiology Association

Correspondence to: Antony Raikhlin, 16 Mendel Cres, Thornhill, ON L4J 9B6; telephone 905 326-9144; e-mail antony.raikhlin{at}utoronto.ca

OBJECTIVE To review evidence supporting the use of uterine fibroid embolization (UFE) as an alternative to hysterectomy and myomectomy for managing uterine fibroids.

QUALITY OF EVIDENCE MEDLINE was searched using the MeSH terms embolization, therapeutic; leiomyoma; treatment outcome; pregnancy; and clinical trials. Most published studies on use of UFE for management of uterine fibroids provide level II evidence.

MAIN MESSAGE For 71% to 92% of patients, UFE is effective at alleviating fibroid-related symptoms. After UFE, fibroids are reduced in size by 42% to 83%. Patients’ satisfaction with the procedure is high (>90%), and UFE is safe and has a low rate of major complications (1.25%). When compared with hysterectomy, UFE is associated with fewer major complications, shorterhospital stays, and faster recovery. Although successful pregnancy following UFE is possible, there is insufficient evidence to advocate use of UFE over myomectomy for management of uterine fibroids in women wishing to preserve fertility.

CONCLUSION For treatment of symptomatic uterine fibroids, UFE is a safe and effective nonsurgical alternative to hysterectomy and myomectomy.






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