Embolisation vs Myomectomy: Which Will Get Me Back to Life Faster?

Medicine Made Simple Summary

When uterine fibroids cause heavy bleeding, pain, or pressure, two common treatments often come up: Uterine Fibroid Embolisation (UFE) and Myomectomy. Both relieve symptoms, but they’re very different in how they’re done, how long recovery takes, and whether the uterus is preserved. UFE is a minimally invasive image-guided procedure performed by an interventional radiologist, while myomectomy is a surgical operation performed by a gynaecologist. This guide explains both treatments, compares their recovery times, results, and long-term effects, and helps you decide which may help you get back to normal life faster.

1. Understanding fibroids and why treatment is needed

Fibroids are non-cancerous growths of muscle and fibrous tissue that form in the wall of the uterus. They’re very common—up to 70% of women develop them by age 50. Many never notice them, but for others, fibroids cause heavy menstrual bleeding, pelvic pressure, bloating, pain, or even fertility issues.

For women seeking relief, the treatment goal is simple: get rid of the symptoms without losing the uterus or spending weeks recovering.

That’s where two main choices appear—Uterine Fibroid Embolisation (UFE) and Myomectomy.

2. What is Uterine Fibroid Embolisation (UFE)?

UFE (also called Uterine Artery Embolisation) is a minimally invasive, non-surgical procedure performed by an interventional radiologist.

Here’s how it works:
A thin catheter is inserted through a small puncture in the groin or wrist. Using real-time X-ray imaging, the doctor guides the catheter to the arteries that supply blood to the fibroids. Tiny particles are injected to block those arteries, cutting off the fibroid’s blood supply. Without oxygen and nutrients, the fibroids shrink over time, and symptoms gradually improve.

The procedure takes about an hour. Patients usually go home the same day or after a short overnight stay. No stitches are needed, and the uterus remains intact.

Within weeks to months, fibroids shrink significantly, and most women experience major relief from heavy bleeding and pelvic pressure.

3. What is a Myomectomy?

Myomectomy is a surgical procedure where a gynaecologist removes fibroids while leaving the uterus in place. It can be performed in different ways depending on fibroid size, number, and location:

• Open (abdominal) myomectomy: A large incision is made across the lower abdomen to remove fibroids directly.

• Laparoscopic myomectomy: Small incisions and a camera allow surgeons to remove fibroids using thin instruments.

• Hysteroscopic myomectomy: Fibroids inside the uterine cavity are removed through the vagina using a special scope.

Myomectomy is often chosen by women who plan to have children, since it removes fibroids while preserving fertility. Recovery, however, depends on the type—ranging from a few days (hysteroscopic) to several weeks (open surgery).

4. The key difference: minimally invasive vs surgical

At the heart of this decision lies one major difference—how invasive the procedure is.

UFE doesn’t involve cutting into the uterus or removing fibroids directly. Instead, it works by starving the fibroids so they shrink naturally. This means:

• Less bleeding

• Less pain

• Shorter recovery

• Fewer complications

Myomectomy, though effective and fertility-preserving, involves either incisions on the uterus or abdominal wall. Healing takes longer, and hospitalisation is usually required.

The choice depends on your personal situation, medical history, and goals—especially around fertility and long-term plans.

5. Comparing recovery and return to normal life

One of the most common questions women ask is, “How long will it take for me to get back to work or daily activities?”

Here’s a general comparison:

After UFE:

• Hospital stay: Usually same-day discharge or one night.

• Return to work: Within 7–10 days.

• Full recovery: About 2 weeks.

• Pain: Mild to moderate cramps for a few days, managed with medication.

• Scarring: Minimal (tiny puncture mark).

After Myomectomy:

• Hospital stay: 1–4 days (depending on approach).

• Return to work: 2–6 weeks (shorter for laparoscopic, longer for open surgery).

• Full recovery: 4–8 weeks.

• Pain: Moderate to severe initially, requiring stronger pain control.

• Scarring: Small or large incision marks depending on type.

In short, UFE offers faster recovery and less downtime, while myomectomy takes longer but allows the direct removal of fibroids.

6. Comparing effectiveness and long-term outcomes

Both treatments effectively reduce fibroid symptoms, but results differ slightly depending on goals.

• Symptom relief: Studies show about 85–90% of women get major relief from UFE, similar to myomectomy results.

• Fibroid recurrence: Fibroids can regrow or new ones can form. UFE has a slightly higher chance of recurrence, since not every fibroid may be fully treated.

• Reintervention rate: Some women who undergo UFE may need a second procedure or surgery years later (about 15–20% within 5 years).

• Fertility: Myomectomy remains the standard for women planning pregnancy, while UFE may reduce fertility slightly in some cases.

If your main concern is getting your life back quickly and avoiding major surgery, UFE is often the better option. If your main concern is future pregnancy, myomectomy may be more suitable.

7. How the procedures feel for the patient

Many women fear both treatments initially, imagining pain or long hospital stays. In reality, both procedures are well-tolerated and guided by expert care.

During UFE, you’re awake but sedated. You might feel mild pelvic pressure or warmth when the embolic particles are released, but no sharp pain. Most women go home within 24 hours and return to work within a week.

During Myomectomy, general anaesthesia is used, so you’ll be asleep. Recovery depends on the surgical method—laparoscopic patients often resume light work in 2–3 weeks, while open surgery may require up to 6 weeks.

8. Safety and potential risks

Both treatments are considered safe when performed by experienced specialists.

Possible UFE risks:

• Post-embolisation syndrome (cramps, fever, nausea for a few days)

• Rare infection or need for antibiotics

• Rare premature menopause (in women over 45)

• Small risk of needing further treatment later

Possible Myomectomy risks:

• Bleeding during surgery

• Risk of infection or scar tissue (adhesions)

• Risk of uterine rupture in future pregnancies (rare)

• Longer anaesthesia and hospital stay

Your doctor will assess your individual health, fibroid size, and age to determine which carries fewer risks for you personally.

9. How to choose between UFE and Myomectomy

Choosing the right treatment is deeply personal. Ask yourself—and your doctor—these questions:

• What are my main symptoms, and how much do they affect my life?

• Do I want to have children in the future?

• How large or numerous are my fibroids?

• Am I comfortable with a longer recovery or would I prefer a faster return to normal life?

• What experience does my hospital or doctor have with each procedure?

For many women who are done with childbearing and want fast relief, UFE offers the best balance of effectiveness, safety, and quick recovery.

For those who still plan pregnancy or whose fibroids are extremely large, myomectomy may be the preferred route.

10. Realistic expectations after treatment

After UFE, your periods usually become lighter, pelvic pressure decreases, and energy levels improve as anaemia resolves. The uterus and fibroids shrink gradually over a few months.

After Myomectomy, results are often immediate since the fibroids are physically removed. However, if new fibroids form later, symptoms may return, requiring repeat surgery or UFE in the future.

In both cases, regular follow-up with your gynaecologist or interventional radiologist is essential.

Conclusion 

If uterine fibroids are affecting your quality of life, know that you have real choices.
Both Uterine Fibroid Embolisation and Myomectomy are proven treatments. The key is to choose the one that fits your goals—whether that’s preserving fertility, minimizing downtime, or avoiding surgery altogether.

AAsk your doctor, “Can I meet with an interventional radiologist to discuss embolisation as an option?” Getting a second opinion often helps you make the best-informed choice. The right treatment isn’t just about removing fibroids—it’s about helping you reclaim your health, energy, and everyday life