Embolization or surgery?
Three routes for fibroids, side by side: keep the uterus, or settle it for good.
OVERVIEW
For symptomatic fibroids you usually have three routes: hysterectomy, myomectomy, and uterine fibroid embolization (UFE). Dr Marios Agathangelou performs UFE, the non-surgical option, in Nicosia and Limassol, Cyprus — covered by GESY, €0 for GESY beneficiaries. UFE shrinks the fibroids through a 1–2 mm incision and keeps the uterus; a hysterectomy removes the uterus; a myomectomy cuts the fibroids out and keeps it. Which one is right depends on your symptoms, your fibroids, and whether you want to keep the option of pregnancy.
The pages below set the three options side by side, in plain terms, so you can see where each one fits before you decide.
THE THREE OPTIONS
HYSTERECTOMY
MYOMECTOMY
EMBOLIZATION
SIDE BY SIDE
| EMBOLIZATION (UFE) | SURGERY | |
|---|---|---|
| What is removed | Nothing; the fibroids are starved and shrink | The fibroids (myomectomy) or the uterus (hysterectomy) |
| Uterus kept | Yes | Myomectomy yes · hysterectomy no |
| Anaesthetic | Local + sedation | General |
| Back to routine | ~1 week | Several weeks |
| Pregnancy after | Possible, but less studied | Myomectomy is usually preferred for this |
| Further treatment later | Somewhat more likely | Hysterectomy is definitive |
| GESY | Covered: €0 for the procedure | Covered |
WHO EACH SUITS
Embolization tends to suit you if you want to keep your uterus, you would rather avoid an operation, you have several fibroids, or a general anaesthetic carries extra risk for you.
Surgery tends to suit you if a future pregnancy is your priority (myomectomy), if you want a single definitive answer and are done with childbearing (hysterectomy), or if the size and position of the fibroids make embolization a poor fit.
This is a decision to make with your gynaecologist, not around them. I am glad to speak with yours directly.
GESY COVER
GESY covers all three. For embolization, the treatment is part of the inpatient admission, so you pay nothing for the procedure itself. Cost is not the reason to pick one over another here.
The first outpatient visit, where we decide what suits you, may carry a small GESY co-payment like any specialist visit. You need a valid referral from your personal doctor or a specialist.
COMMON QUESTIONS
Dr Marios Agathangelou, an interventional radiologist, sees patients in Nicosia and Limassol and performs uterine fibroid embolization. It is covered by GESY — €0 for GESY beneficiaries.
Neither wins on its own. It depends on your symptoms, the size and number of fibroids, and whether you want to keep the uterus or plan a pregnancy. A good answer comes from looking at your case, not at averages.
With embolization and with myomectomy, yes. A hysterectomy removes it. If keeping the uterus matters to you, say so early; it narrows the choice quickly.
For fertility, myomectomy is usually recommended first, because the evidence for it is stronger. Pregnancies do happen after embolization, but it is less studied. We weigh this with a gynaecologist before deciding.
A proportion of women treated with embolization need a further procedure years later, a higher proportion than after a hysterectomy, which is final. That trade-off is part of the decision and I will not skip it.
Yes. All three are covered. For embolization you pay €0 for the procedure. So the choice is about what fits your body and your plans, not about cost.
SOURCES
Comparisons on this page follow the CIRSE Standards of Practice for uterine artery embolization and the patient guidance of the Society of Interventional Radiology and the Royal College of Obstetricians and Gynaecologists. They describe the options in general; they are not advice about your case.
Bring your ultrasound or MRI. We decide together.
In a consultation I look at your fibroids, your symptoms and your plans — and tell you plainly which path fits.
Cramping in the first days is expected and managed with medication; most women return to routine within a week.