UTERINE ARTERY EMBOLIZATION FOR FIBROIDS AN ALTERNATIVE TO HYSTERECTOMY

Abstract

Background: Uterine fibroids, or leiomyomas, are common benign tumors affecting women of reproductive age and often present with symptoms such as heavy menstrual bleeding, pelvic pain, and pressure effects. Hysterectomy has long been the definitive treatment; however, uterine artery embolization (UAE) has emerged as a minimally invasive alternative aimed at preserving the uterus. Evaluating the comparative safety and effectiveness of UAE versus hysterectomy can guide treatment decisions for symptomatic fibroid uterus.

Objective: To determine the effectiveness of uterine artery embolization in the treatment of symptomatic uterine fibroids compared to hysterectomy.

Methods: This prospective observational study was conducted at the Armed Forces Institute of Radiology and Imaging, Rawalpindi, from March 2023 to September 2023. A total of 60 women diagnosed with uterine fibroids were enrolled using non-probability convenience sampling. Participants were equally allocated into two groups: Group A underwent uterine artery embolization, and Group B underwent hysterectomy. Post-treatment outcomes assessed included bleeding from the surgical site, postoperative pain, hospital discharge within 24 hours, mechanical ventilation requirement, HDU admission, and mortality. Data were analyzed using SPSS version 26.0, with the chi-square test applied to compare outcomes (p<0.05 considered significant).

Results: Group A showed lower rates of bleeding from the surgical site (16.6%) compared to Group B (46.6%). Postoperative pain was reported in 26.6% of UAE patients versus 70% in the hysterectomy group. Early discharge within 24 hours was achieved in 80% of UAE cases versus 16.6% in the hysterectomy group. Mechanical ventilation was required in 6.6% and 40% of patients, respectively. Mortality was nil in both groups.

Conclusion: Uterine artery embolization demonstrated fewer complications, faster recovery, and comparable clinical outcomes, suggesting it may serve as a viable alternative to hysterectomy for the treatment of symptomatic uterine fibroids.