Regarding uterine artery embolisation (UAE) for symptomatic uterine fibroids, which outcome parameter is BEST supported by current evidence compared to surgical myomectomy?
- A Non-inferior symptom improvement with shorter hospital stay and quicker recovery ✓
- B Lower fibroid recurrence at 5 years
- C Better fertility outcomes after the procedure
- D Lower rate of subsequent hysterectomy within 10 years
Correct answer: A. Non-inferior symptom improvement with shorter hospital stay and quicker recovery
Explanation
Large RCTs (REST trial, EMMY trial) have shown that UAE achieves non-inferior symptom control for menorrhagia and bulk symptoms compared to surgical myomectomy or hysterectomy, with the advantage of shorter hospital stay, faster recovery, and avoidance of general anaesthesia. However, UAE has higher rates of re-intervention (repeat UAE or eventual hysterectomy) at 5–10 years. It is not recommended as a fertility-sparing procedure of choice, as adverse effects on ovarian reserve and uterine healing have been reported.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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Written and medically reviewed by the StethoPrep medical team.