UFE vs. Myomectomy: A Less Invasive Way to Treat Fibroids

If you’ve been diagnosed with uterine fibroids, chances are your doctor has already thrown a few treatment names at you — and if “myomectomy” was one of them, you might be wondering if there’s a less daunting option. Good news: there is. Uterine fibroid embolization, or UFE, is a non-surgical fibroid treatment that’s helping more and more women skip the operating room entirely. But how does UFE vs. myomectomy stack up to one another?

What are Uterine Fibroids?

Uterine fibroids are noncancerous growths that develop in or around the uterus. They’re incredibly common — up to 80% of women will have them by age 50 — and while some women never feel a thing, others deal with heavy periods, pelvic pain, bloating, fatigue, and even fertility challenges. When fibroids start affecting your quality of life, that’s when treatment enters the conversation.

Two of the most commonly compared options for women who want to keep their uterus are UFE vs. myomectomy.

What Is a Myomectomy?

A myomectomy is a surgical procedure that removes fibroids while leaving the uterus intact. Think of it as fibroid removal without going all the way to a hysterectomy. It’s a meaningful distinction for women who still want the option of pregnancy or simply want to preserve their uterus.

There are three types, and they vary quite a bit in how involved the surgery is. An abdominal (or “open”) myomectomy involves a horizontal incision along the bikini line and is typically used for large or deeply embedded fibroids — it’s the most invasive version and requires a hospital stay. A laparoscopic myomectomy uses small incisions and a camera, making it less invasive with a shorter recovery. A hysteroscopic myomectomy is the least invasive of all, performed through the vagina with no incisions — though it’s only an option for smaller fibroids located inside the uterine cavity.

Myomectomy can be very effective, and many women experience significant relief from heavy bleeding and pelvic pain afterward. The catch is it’s still surgery, with all the risks that come with it — bleeding, infection, anesthesia complications, and a recovery that can stretch anywhere from a week to six weeks, depending on which type you have.

What Is UFE?

Uterine fibroid embolization (UFE) — also called uterine artery embolization, or UAE — takes a completely different approach. Instead of cutting fibroids out, UFE starves them. The procedure works by blocking the blood vessels that supply fibroids with the nutrients they need to survive. Without blood flow, the fibroids shrink and die on their own over the following weeks and months.

Here’s what the procedure looks like: an interventional radiologist makes a tiny incision in your wrist or groin, then guides a thin catheter through your artery to the uterine blood supply. From there, tiny particles roughly the size of grains of sand are injected to block the flow to the fibroids. The whole thing typically takes about an hour; it’s done under light sedation rather than general anesthesia, and most women go home the same day.

One of the biggest advantages of UFE vs. myomectomy are that UFE treats all fibroids at once, regardless of size, number, or location — something myomectomy can’t always achieve. And because it’s a non-surgical fibroid treatment, recovery is dramatically shorter.

How Does Recovery Compare?

This is often where people’s jaws drop a little. UFE recovery typically runs about 7 to 10 days, with most women back to normal activities within two weeks. You’ll likely have some cramping and fatigue in the first few days, which is completely normal and manageable with over-the-counter pain medication.

Myomectomy recovery is different. An abdominal myomectomy can mean four to six weeks of recovery, including limits on lifting and activity. Laparoscopic myomectomy is better — usually two to four weeks — and hysteroscopic recovery is the shortest at around three to five days. Even in the best-case surgical scenario, you’re looking at more downtime, more hospital involvement, and generally a harder road back.

For women with jobs, kids, or simply lives they can’t put on hold for over a month, UFE’s recovery timeline can be a genuine game-changer.

How is Fertility Affected?

This is the question on a lot of people’s minds, and it deserves a real answer rather than a vague “talk to your doctor.”

Myomectomy has traditionally been the go-to recommendation for women who want to get pregnant after fibroid treatment, largely because it physically removes the fibroids. That said, surgery always carries a risk of uterine scarring, which can itself create fertility challenges. Women who’ve had an abdominal myomectomy are also typically advised to deliver by C-section in any future pregnancy to reduce the risk of uterine rupture.

UFE and fertility is a more nuanced picture. Studies have shown that pregnancy is absolutely possible after UFE, and more recent research suggests that fertility outcomes between the two procedures are becoming more comparable than once thought. However, because UFE affects blood flow to the uterus more broadly, it isn’t yet considered the first-line recommendation for women who are actively trying to conceive in the near term. If pregnancy is a near-term priority, that conversation with your specialist really matters.

Both procedures preserve the uterus, and both can be compatible with future pregnancies — but your individual situation, fibroid type, and family planning timeline should all factor into the decision.

Do Fibroids Come Back?

Here’s a meaningful difference between the two. With myomectomy, fibroids are surgically removed, but the underlying conditions that caused them to grow haven’t changed. Studies show a recurrence rate of around 60% within five years of myomectomy, meaning many women end up needing repeat treatment down the road.

UFE has a significantly lower recurrence rate. Because it targets the blood supply to the entire uterus rather than removing individual fibroids, it tends to provide more durable long-term relief. Around 85 to 90% of women report significant symptom improvement after UFE — and that relief tends to stick.

Which One Is Right for You?

There’s no single right answer — it really does depend on your specific situation. UFE tends to be a strong fit for women who have multiple fibroids, want to avoid surgery, have a shorter recovery window available, or aren’t actively trying to get pregnant in the near future. It’s also covered by most major insurance plans, just like myomectomy.

The most important thing is knowing that you have real, effective options beyond surgery. If you’ve only been offered a surgical route so far, it’s absolutely worth asking about UFE or scheduling a consultation with an interventional radiologist who specializes in it.

The Takeaway

Fibroids are common. The suffering they cause doesn’t have to be. Whether you’re leaning toward UFE vs. myomectomy, the fact that you’re researching your options puts you ahead. Both procedures can bring meaningful relief — but for many women, UFE offers that relief with less time under sedation, fewer risks, a faster recovery, and no surgical incision.

For more information about uterine fibroid embolization, or to schedule a consultation with one of our doctors, please visit our contact page or call (720) 516-0637.