UFE vs Myomectomy: Understanding the Pros and Cons

This article was medically authored by Dr. Eric Hardee and was last reviewed for accuracy on 11/09/2026.

There are several options to explore for the treatment of uterine fibroids. For years, doctors told women suffering from fibroid symptoms that their only option for relief was a hysterectomy (surgical removal of the uterus.) However, there are less invasive treatment options, including surgical removal of individual tumors (myomectomy) and a procedure that shrinks tumors by reducing their blood supply (UFE, or Uterine Fibroid Embolization.)

When comparing UFE vs Myomectomy as potential treatment options, there are many factors to consider, including safety, efficacy, cost and recovery time. In this post, we highlight the pros and cons of each option, to help you make the best treatment choice for your needs.

Key Takeaways

• Myomectomy is a surgery that removes individual fibroids
• Uterine Fibroid Embolization is an interventional radiology procedure that shrinks fibroids without surgery, by starving them of blood supply
• Research reveals that efficacy for UFE vs Myomectomy is similar; however, UFE allows women to avoid general anesthesia, overnight hospital stays and extended recovery periods

Less Invasive Treatment of Uterine Fibroids: UFE vs Myomectomy

Minimally invasive UFE shrinks fibroids by cutting off blood flow to the tumors. During this procedure, an interventional radiologist accesses the uterine artery via catheter, using a small access point. Then, guided by ultrasound, embolic material is deposited, reducing blood flow to the fibroids and causing them to shrink gradually in the weeks and months following the procedure.

In contrast, a myomectomy surgically removes individual tumors. There are three different types of myomectomy surgery:

1. Hysteroscopic — This approach uses a thin tube to access your uterine cavity. The surgeon can then lift the uterine walls and shave off fibroids. Performed on an outpatient basis, this is the least invasive myomectomy approach, but it’s only an option for women with fibroids inside the uterine cavity.
2. Laparoscopic — Not available to women with large or multiple fibroids, this approach allows surgeons to access your uterus with small abdominal incisions, reducing recovery time and scarring compared to open surgery. This option is also not available to women whose fibroids with intramural fibroids that are deep within the uterine wall.
3. Abdominal — This open surgical procedure requires major incisions in your lower abdomen and uterine area, giving surgeons the access needed to remove large or deeply embedded tumors.

Because tumors are removed with all of these myomectomy approaches, symptom improvement may become apparent earlier than with UFE. However, because the procedure is surgical, it comes with more risks for complications, especially if performed as an open surgery, according to new research. Additionally, when myomectomy requires general anesthesia as well as overnight hospital stays, this treatment option can become more costly than UFE. 

Which is Safer, UFE or Myomectomy?

Both procedures are generally considered safe. However, because myomectomy often requires general anesthesia and larger incisions, the risk for associated complications may be higher. Still, some women with large or multiple tumors may be better served by myomectomy than UFE. We can help determine your UFE candidacy with this short and easy quiz.

Myomectomy vs UFE: Relevant Research

Recent studies show that less invasive Uterine Fibroid Embolization is equally as effective as myomectomy surgery for fibroid relief! Specifically, the FEMME study spent 7 years following 950 women with fibroids. Half the study participants underwent the UFE procedure, and half chose myomectomy for treatment of uterine fibroids. Here's what they learned: both procedures effectively reduced symptoms such as heavy bleeding in almost equal measure. And, when it came to follow up treatments, 9.9% of women who had myomectomy needed further treatment, while that was only true for 8.6% of women in the UFE group. Plus, 2.9% of women who chose myomectomy experienced post-procedural complications, versus only 1.1% of women who underwent UFE. As such, lead researcher Dr. Jemianne Bautista-Jia concluded, "The two treatments were comparably effective [and] UFE resulted in more favorable outcomes."

Now, that was not just true for early follow ups. 36 months after their procedures, women who chose myomectomy saw a greater decrease in the size of their largest tumor. However, the women who underwent UFE experienced greater reductions in the size of their enlarged uterus.

Even better news for UFE patients? 29% of myomectomy patients needed a follow-up procedure for the treatment of uterine fibroids, compared to just 24% of women who chose UFE treatment. Plus, twelve of the women who chose UFE reported on their healthy pregnancies, compared to just six women who selected myomectomy.

Clearly, there is a lot to think about when choosing between UFE vs myomectomy to treat your fibroids. At Texas Endovascular, our team is here to help you make your best and most informed decision. To learn more, we invite you to request a consultation at one of our eight locations in the greater Dallas and Houston metro areas.