The big advantage of embolisation over myomectomy in patients with multiple fibroids is that in the overwhelming majority of cases, all the fibroids will be killed at one hit; in other words, once the fibroids are dead, the patient’s situation can only improve. Recurrence rates are extremely low with fibroid embolisation.
This is not the case with myomectomy: the recurrence rate after myomectomy is around 75% and within 5 years 25% of patients who have myomectomies will come to further major surgery and this is usually a hysterectomy. Obviously, since you are looking at a 25% hysterectomy rate approximately after myomectomy, patients should be told about this but they are not told of this major difference between embolisation and myomectomy. They are also often not told of the full list of complications that can occur with both open myomectomy and laparoscopic myomectomy where the complication list is very similar.