A 45-year-old woman with completed family has a 14-week size uterus due to multiple intramural fibroids and heavy menstrual bleeding causing Hb 7.2 g/dL. She declines hysterectomy. MRI shows no submucosal component. Which intervention offers the longest-lasting symptom relief while preserving the uterus?

• A Uterine artery embolisation ✓
• B Levonorgestrel-releasing intrauterine system (LNG-IUS)
• C Endometrial ablation
• D GnRH agonist therapy for 6 months

Explanation

UAE provides durable symptom relief (benefit beyond 5 years) and is the standard uterine-preserving option when medical therapy fails and surgery is declined. LNG-IUS is effective for menorrhagia but is less reliable with a markedly enlarged cavity and intramural bulk. Endometrial ablation alone does not address intramural bulk. GnRH agonists provide only temporary shrinkage and symptoms recur after stopping.

Reference: Te Linde's Operative Gynecology, 12th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.