Fibroid embolization vs myomectomy vs hysterectomy: which option to choose?
Detailed comparison of uterine fibroid treatments: advantages, limitations, recovery, fertility et remboursement
| Criterion | Embolization (UFE) | Myomectomy | Hysterectomy |
|---|---|---|---|
| Anaesthesia | Local + sedation | General or spinal | General |
| Hospital stay | 1 to 2 nights | 2 to 5 days | 3 to 5 days |
| Recovery | 5 to 10 days | 4 to 6 weeks | 4 to 8 weeks |
| Incision | 2 mm groin puncture | Laparotomy or laparoscopy | Laparotomy or laparoscopy |
| All fibroids | Yes (simultaneously) | No (targeted only) | Yes (complete removal) |
| Possible recurrence | Yes (5-15% at 5 years) | Yes (20-30%) | No (no uterus) |
| Uterus preserved | Yes | Yes | No |
| Pregnancy possible after | Yes | Yes | No |
| Reimbursement | 100% (national insurance) | 100% (national insurance) | 100% (national insurance) |
The French health authority (HAS) and the college of gynaecologists (CNGOF) recognise uterine artery embolization as a valid alternative to surgery for symptomatic fibroids, with an equivalent level of evidence. The choice should be discussed in a multidisciplinary consultation, taking any pregnancy plans into account.
Embolization: advantages and limitations
Advantages: minimally invasive treatment with no significant incision, short hospital stay (1-2 nights), quick return to activities (5-10 days), simultaneous treatment of all fibroids, preservation of the uterus and possibility of later pregnancy, effective on multi-fibroid uterus.
Limitations: post-embolization syndrome in the first 24-48h (expected, managed pain), not indicated for an isolated pedunculated submucosal fibroid (hysteroscopy preferred), risk of long-term recurrence (5-15% at 5 years requiring further treatment).
Myomectomy: advantages and limitations
Advantages: physical removal of the targeted fibroids, gold-standard treatment for submucosal fibroids via hysteroscopy, indicated when a diagnostic doubt requires pathological analysis.
Limitations: treats only the targeted fibroids (not the others), high 5-year recurrence rate (20-30%), possible surgical complications (haemorrhage, post-operative adhesions), long recovery (4-6 weeks).
Frequently asked questions
Is embolization as effective as surgery?
Can you become pregnant after fibroid embolization?
Can embolization fail and require surgery?
Which option if I want to preserve my chances of pregnancy?
Everything about the technique, procedure and results of fibroid embolization.
Why this page is trustworthy
Written by the Interventional Radiology team at Cochin Hospital AP-HP, Université Paris Cité. Medically reviewed by an interventional radiologist of the department. Last updated: August 2026.