<b>Impact of Uterine Artery Embolization in Symptomatic Uterine Fibroids: A Single Central Study</b>

Background: Uterine fibroids are the most common benign tumors in women, significantly contributing to gynecologic morbidity worldwide. Uterine fibroid embolization (UFE) offers a minimally invasive, uterus-sparing treatment alternative but remains underutilized in developing countries, where disease burden is substantial and local outcome data are limited. Objective: To evaluate the impact of UFE on clinical symptoms and imaging outcomes in women with symptomatic fibroids treated at a tertiary care hospital in Karachi, and to explore the relationship between radiological changes and symptom improvement. Methods: This retrospective and prospective cohort study included 51 women with symptomatic uterine fibroids undergoing UFE from June to December 2024. Baseline and three-month follow-up MRI assessed uterine and dominant fibroid volumes, while symptom severity scores were collected at baseline and six months post-UFE using a validated questionnaire. Statistical analyses compared pre- and post-procedure measures and assessed correlations between volume reduction and symptom change. Results: Mean reductions were 43.7% for dominant fibroid volume, 40.1% for uterine volume, and 37.8% for symptom severity score (all p<0.001). No significant correlation was observed between volume reduction and symptom score improvement (ρ = –0.08, p = 0.568 for uterine volume; ρ = –0.14, p = 0.278 for dominant fibroid volume). Conclusion: UFE achieved significant clinical and radiological improvements in this cohort, independent of baseline fibroid burden, supporting its broader adoption as a safe and effective alternative to hysterectomy.