Minimally invasive and ablative therapies for symptomatic uterine fibroids: a narrative review

Purpose of review Uterine fibroids are benign smooth muscle growths that can cause abnormal uterine bleeding, bulk symptoms, and infertility. Traditional treatments include medical therapy and surgical interventions such as hysterectomy and myomectomy. In the past three decades, minimally invasive, uterus-sparing alternatives – namely, high-intensity focused ultrasound (HIFU), uterine artery embolization (UAE), and radiofrequency ablation (RFA) – have revolutionized the management of symptomatic fibroids. Although early studies suggest these modalities are effective, high-quality data on their long-term efficacy, safety profiles, and reproductive outcomes are limited. Recent findings This paper presents a literature review on HIFU, UAE, and RFA for the treatment of symptomatic uterine fibroids. Studies report improvements in symptom severity and quality of life, with low complication rates. Optimal outcomes depend on careful patient selection, as certain factors increase the risk of treatment failure and the need for reintervention. Furthermore, little is known about pregnancy outcomes following these interventions, as studies are sparse and heterogenous. Summary HIFU, UAE, and RFA are safe and effective options for the treatment of symptomatic uterine fibroids. Further research is needed to evaluate long-term effectiveness, fertility and pregnancy outcomes, and comparisons between treatment modalities.