Does Pre-operative Uterine Artery Embolization Improve Myomectomy Outcomes? A Systematic Review and Meta-analysis

Uterine artery embolization (UAE) has been proposed as an adjunct to myomectomy to reduce surgical morbidity. This meta-analysis evaluates the impact of UAE with myomectomy versus myomectomy alone on intraoperative and postoperative outcomes.

A systematic review and meta-analysis were conducted following PRISMA guidelines. We searched PubMed, Scopus and EMBASE databases until June 2025 using comprehensive search strategies. Studies were included if they evaluated pre-operative UAE followed by myomectomy in women with symptomatic uterine fibroids, reporting at least one primary outcome (intraoperative blood loss, operative time, or need for blood transfusion).

our study showed a significant reduction in intraoperative blood loss with UAE (MD: –49.49 mL; 95% CI: [–79.34, –3.64]; p = 0.0055). Operative time showed no significant difference (MD: 1.91 minutes; 95% CI: [–26.97, 30.80]; p = 0.896). The need for transfusion (RR: 0.30; 95% CI: [0.09, 1.01]; p = 0.0524) and postoperative complications (RR: 0.86; 95% CI: [0.42, 1.74]; p = 0.6714) were not significantly different between groups

pre-operative UAE looks to have potential as a beneficial addition to myomectomy, especially for women who have massive or numerous fibroids who are at high risk of substantial hemorrhage.