If you’ve been diagnosed with symptomatic fibroids, you may be facing a decision between several very different treatment paths. Here’s how uterine fibroid embolization (UFE), myomectomy, and hysterectomy compare.
Hysterectomy
A hysterectomy is the surgical removal of the entire uterus. Because the source of the fibroids is removed entirely, it’s the most definitive treatment — fibroid symptoms cannot return after a hysterectomy. However, it’s also the most invasive option, requiring a longer recovery, carrying surgical risks like any major operation, and it permanently ends the ability to carry a pregnancy. For women who are finished having children and want a permanent solution, hysterectomy remains a reasonable option, but it’s a significant decision.
Myomectomy
A myomectomy surgically removes the fibroids themselves while leaving the uterus intact, preserving the potential for future pregnancy. It can be performed through an abdominal incision, laparoscopically, or hysteroscopically depending on the size and location of the fibroids. While myomectomy avoids removing the uterus, it still carries typical surgical risks — bleeding, infection, and a recovery period that can take several weeks — and because the uterus remains, new fibroids can develop over time, meaning symptoms can eventually return.
Uterine Fibroid Embolization (UFE)
UFE takes a fundamentally different, non-surgical approach. Instead of removing the fibroids or the uterus, an interventional radiologist threads a small catheter into the arteries feeding the fibroids and injects tiny particles that block their blood supply. Without blood flow, the fibroids shrink over time — and in some cases disappear entirely.
Because there’s no incision beyond a small puncture site, UFE is performed as an outpatient procedure under moderate sedation rather than general anesthesia. Most patients go home the same day and return to normal activity within days rather than weeks, and because there’s no trauma to the uterus itself, fertility is preserved for women who wish to have children in the future.
Comparing the Three Options
- Preserves the uterus: UFE and myomectomy do; hysterectomy does not.
- Recovery time: UFE typically has the shortest recovery, often just a few days; myomectomy and hysterectomy involve weeks of healing.
- Anesthesia: UFE uses moderate sedation; myomectomy and hysterectomy typically require general anesthesia.
- Chance of symptoms returning: Possible with myomectomy if new fibroids form; not possible after hysterectomy; UFE treats all existing fibroids in a single session.
- Effectiveness: Data supports UFE as an equally effective alternative to surgery for relieving fibroid symptoms, with less risk and a substantially easier recovery.
Which Treatment Is Right for You?
The best option depends on your symptoms, the size and location of your fibroids, whether you hope to have children in the future, and your personal preferences around surgery. Many women who want to avoid surgery, preserve their uterus, or simply get back to normal life faster find UFE to be the right fit — but a conversation with a specialist is the best way to know for sure.
Want to understand fibroids from the ground up first? Read our companion post, Uterine Fibroids Explained. If you’re in the Kansas City area, learn more on our Uterine Fibroid Embolization page, or take our fibroid quiz to see if UFE may be right for you.