Recurrence after Uterine Fibroid Embolization

If embolization is carried out by a skilled and experienced operator the recurrence rate should be around 1-2%

The incidence of recurrence after fibroid embolization is very low. Often what is labelled as recurrence is really under-embolization of the fibroid mass in the first place leaving some residual fibroids still viable. In a number of cases this does not actually matter as the fibroids may well be small and inconsequential, but in other cases re-embolization is required.

If embolization is carried out by a skilled and experienced operator, then the so-called recurrence rate and re-embolization rate should be very low (around 1-2%). This may be slightly higher in young Afro-Caribbean women where the embolization is maybe undertaken at an earlier age as the disease is more aggressive in this particular group. Obviously if the Radiologist performing the embolization is insufficiently skilled or experienced then the rate of inadequate embolization and therefore persistent fibroid viability is going to be higher and, indeed, in the MARA Trial from the Czech Republic there was a technical failure rate of embolization of something around 10%, with a failure to kill the dominant fibroid of 30%. This is hopeless as the figure should be 1-2%.

The Radiologists doing this were however very inexperienced Radiologists who had been given no training in fibroid embolization. Unfortunately, in the early days of fibroid embolization it was all too common for Gynaecologists to ask Interventional Radiologists to perform fibroid embolizations who were either very inexperienced or indeed had done none at all.

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Dr. Walker is a Consultant Diagnostic and Interventional Radiologist who pioneered UFE in the UK as Lead Clinician at the Royal Surrey County Hospital, Guildford

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