Comparing clinical characteristic with uterine artery embolization versus laparoscopic hysterectomy in symptomatic uterine fibroids - A prospective, single-institution study

Kazuki Anyo, Kazuki Anjo, Hyo Kyozuka, Riho Yazawa, Toma Fukuda, Takahiro Omoto, Chihiro Okoshi, Daisuke Suzuki, Tokiya Ishida, Takuya Ando, Tatsuya Ando, Tadanobu Tameda, Tadanobu Tameta, Hiroko Kobayashi, Shun Yasuda, Yasuhisa Nomura, Shu Soeda, Keiya Fujimori
European journal of obstetrics, gynecology, and reproductive biology · 2025 · vol. 316 , pp. 114806 · doi:10.1016/j.ejogrb.2025.114806 · PMID:41223826 · W4415845400
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This prospective study compared the clinical characteristics of uterine artery embolization and laparoscopic hysterectomy for symptomatic uterine fibroids, detailing differences between the two treatments.

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Abstract

OBJECTIVE: This study aimed to identify clinical indications for uterine fibroid (UF) treatment by comparing patient characteristics and imaging findings in cases treated with uterine artery embolization (UAE) or total laparoscopic hysterectomy (TLH). MATERIAL AND METHODS: This prospective cohort study was conducted at a single center in Fukushima, Japan, and included 80 women who underwent UAE and 119 who underwent TLH for symptomatic UF between October 1, 2020, and May 31, 2025. Treatments, including hormonal therapy, myomectomy, hysterectomy, and UAE, were selected based on individual patient needs. Clinical and magnetic resonance imaging (MRI) findings were compared between groups. MRI parameters included uterine length (LU), depth (DU), number of fibroids (NF), and largest fibroid diameter (LFD). Receiver operating characteristic (ROC) curves were generated using UAE as the outcome variable for significantly different continuous variables, and cutoff values were derived from the area under the curve (AUC). RESULTS: A higher proportion of patients in the TLH group had a history of delivery (87.4 %) compared to the UAE group (57.5 %). The UAE group had significantly higher median values for LU (126 mm vs. 94 mm), DU (91 mm vs. 65 mm), NF (6 vs. 2), and LFD (69 mm vs. 47 mm) (all p < 0.01). ROC analysis showed the AUC for DU was 0.79, with a cutoff value of 82 mm (sensitivity 0.70, specificity 0.76). CONCLUSION: The findings indicate distinct clinical and imaging characteristics associated with UAE and TLH. These parameters may assist gynecologists in identifying suitable candidates for UAE in the management of symptomatic uterine fibroids.

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MeSH descriptors

Hysterectomy Hysterectomy Laparoscopy Leiomyoma Leiomyoma Leiomyoma Leiomyoma Uterine Artery Embolization Uterine Neoplasms Uterine Neoplasms Uterine Neoplasms Uterine Neoplasms Adult Female Humans Magnetic Resonance Imaging Middle Aged Prospective Studies Uterus Uterus

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