Impact of Uterine Artery Embolization in Symptomatic Uterine Fibroids: A Single Central Study

Background: Uterine fibroids are the most common benign pelvic tumors in women and often cause substantial morbidity. Uterine artery embolization has emerged as a minimally invasive alternative to surgery, yet there is limited data from South Asian populations regarding its clinical and radiological efficacy. Objective: To evaluate the impact of uterine artery embolization on fibroid and uterine volumes and symptom severity in women with symptomatic uterine fibroids and to examine the association between imaging and clinical outcomes in a local tertiary care context. Methods: This prospective and retrospective cohort study was conducted at the Department of Radiology, Indus Hospital and Health Network, Karachi, from June to December 2024. Consecutive women undergoing embolization for symptomatic fibroids were enrolled. Baseline and three-month MRI volumetry, as well as six-month symptom severity scores, were collected and analyzed using standardized protocols. Associations between changes in imaging and symptom outcomes were assessed using appropriate inferential statistics. Results: Fifty-one women were included (mean age 40.4 years). Mean uterine and dominant fibroid volumes decreased by 40.1% and 43.7%, respectively, and symptom severity scores improved by 37.8% at follow-up (all p < 0.001). No statistically significant correlation was found between imaging volume reduction and symptom improvement. Conclusion: Uterine artery embolization offers significant volumetric and symptomatic benefits for women with symptomatic fibroids in a South Asian tertiary setting. Symptom relief may be independent of imaging changes, emphasizing the importance of patient-reported outcomes in post-procedure care.