Utilization and Outcomes of Uterine Artery Embolization for Fibroid Treatment: A Nationwide Data Analysis

Purpose: Uterine artery embolization (UAE) has emerged as a minimally invasive option for the treatment of symptomatic uterine fibroids. Despite increasing utilization, data on long-term outcomes are limited. To investigate nationwide utilization trends and clinical outcomes of UAE for fibroid treatment using publicly available data from the National Inpatient Sample (NIS).

Materials and Methods: Analysis of NIS data from 2005 to 2020, covering UAE procedures, was conducted. Outcome measures included complication rates, length of hospital stay, and recurrence of fibroid symptoms within 5 years. Outcomes were compared with hysterectomy and myomectomy, with adjustments for patient age, race, and comorbidities.

Results: The number of UAE procedures increased by 65% from 2005 to 2020, with the highest utilization in women aged 40-55. UAE had a 3.2% complication rate, significantly lower than hysterectomy (8.5%, p < 0.001). Hospital stays were shorter for UAE (2.1 days vs. 3.9 days for hysterectomy, p < 0.01). However, 18% of UAE patients reported symptom recurrence within 5 years, compared to 4% for hysterectomy and 6% for myomectomy (p < 0.01).

Conclusion: UAE is a safe and effective alternative to surgery for fibroid treatment, but symptom recurrence is more common. Long-term follow-up and patient counseling are necessary to manage expectations regarding recurrence and additional treatments.