The comparison of myomectomy, UAE and MRgFUS in the treatment of uterine fibroids: a meta analysis

Objective To compare the re-intervention rates of myomectomy, uterine artery embolization (UAE) and magnetic resonance-guided focused ultrasound surgery (MRgFUS) for uterine fibroids (UFs) in different follow-up time. Methods Two investigators searched PubMed for clinical studies published in English from 1 Jan 2000 to 31 Dec 2020, and independently examined the paper to select qualified studies, extracted relevant information and assessed the risk of bias. Meanwhile, a meta-analysis of 31 studies containing totally 42103 patients was conducted to compare the re-intervention rate of myomectomy, UAE and MRgFUS. Results In the meta-analysis of 42103 patients, the 12-month re-intervention rates of myomectomy, UAE and MRgFUS for UFs were 0.06 (95%CI, 0.01–0.11), 0.07 (95%CI, 0.06–0.09), and 0.12 (95%CI, 0.04–0.20) respectively. The 24-month re-intervention rates were 0.10 (95%CI, 0.04–0.16), 0.08 (95%CI, 0.01–0.17), and 0.14 (95%CI, 0.07–0.21) respectively. The 36-month re-intervention rates were 0.09 (95%CI, 0.05–0.13), 0.14 (95%CI, 0.05–0.23), and 0.22 (95%CI, 0.11–0.32) respectively. Additionally, the 60-month re-intervention rates were 0.19 (95%CI, 0.15–0.24), 0.21 (95%CI, 0.17–0.25), and 0.49 (95%CI, 0.21–0.77) respectively. Conclusions The myomectomy has the lowest re-intervention rate of the three regimens in short time and long time while the MRgFUS has the highest. The rate of MRgFUS increased rapidly in the 60th month after the treatment