The Role of Trans-Arterial Embolization in Treatment of Uterine Submucosal Fibroids: Clinical Outcomes and Predictors of Success

Abstract

Background & Objective: Submucosal fibroids are a common cause of abnormal uterine bleeding and infertility. While surgical options exist, Trans-Arterial Embolization (TAE) is a minimally invasive alternative with promising outcomes, particularly in preserving fertility. The present study was conducted with aim to evaluate the effectiveness of TAE in reducing fibroid size and improving bleeding symptoms, and to analyze the influence of fibroid size and menopausal status on treatment outcomes.Materials & Methods: This prospective study was conducted on 35 women (35-55 years) diagnosed with FIGO types 1, 2, or 2-5 submucosal fibroids. Participants were grouped by fibroid size (<5 cm, 5-7 cm, >7 cm). All underwent TAE under local anesthesia. Outcomes were assessed via ultrasound and symptom scoring at baseline, 6 months, and 12 months’ post-procedure. Statistical analysis was performed using SPSS (version 26) and repeated-measures ANOVA, chi-square testing, and logistic regression. P<0.05 was considered statistically significant.Results: Fibroid size reduced by 40% at 6 months and 46% at 12 months. Significant improvement in bleeding was observed in 80% of premenopausal and 50% of postmenopausal women. Menopausal status was a significant predictor of symptom improvement (OR=3.45, P=0.01). No major complications were recorded. Ultrasound revealed post-treatment cystic changes and inhomogeneous echo patterns.Conclusion: TAE is a safe, effective option for treating submucosal fibroids, particularly in premenopausal women and those with smaller fibroids. It offers meaningful symptom relief and preserves fertility, making it a viable alternative to surgery.