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Symptomatic uterine fibroids may be managed surgically, with hysterectomy or myomectomy, or by radiological therapies, including uterine artery embolisation (UAE) or high-intensity focused ultrasound. The specialty societies in the USA (www.acog.org) and the UK (www.rcog.org.uk) and the National Institute for Clinical Excellence have endorsed the safety and short-term efficacy of UAE, but have identified research needs to study long-term symptom relief and fertility effects. Effective non-surgical options for fibroids are needed, particularly to preserve fertility. Short-term follow-up suggests that UAE reduces symptoms and may be more cost effective than surgery.1 Longer follow-up now questions the durability of these outcomes.
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