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Randomised controlled trial
Uterine artery embolisation associated with greater need for reintervention than surgical treatment for symptomatic uterine fibroids; quality of life similar though study underpowered
  1. Martha Hickey,
  2. Jennifer L Marino,
  3. Fiona C Brownfoot
  1. Department of Obstetrics and Gynaecology, The Royal Women's Hospital and University of Melbourne, Victoria, Australia
  1. Correspondence to Martha Hickey
    Department of Obstetrics and Gynaecology, The Royal Women's Hospital and University of Melbourne, Parkville, Melbourne Victoria 3052, Australia; martha.hickey{at}thewomens.org.au

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Context

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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