A major concern following uterus-sparing procedures, particularly myomectomy, is the potential for Recurrence Risk. While myomectomy removes the existing fibroids, it does not alter the underlying hormonal and genetic environment that allowed them to grow initially. Consequently, the development of new fibroids from other uterine muscle cells is a recognized long-term risk, with rates varying widely, but estimated to be as high as 30% to 60% within ten years of the surgery.

Several factors elevate the chance of new growth, including a younger age at the time of the initial surgery, the removal of numerous fibroids, and obesity. Conversely, in ablative procedures like UFE and RFA, where the remaining fibroid tissue is ischemic or necrotic, true regrowth is less common, though new fibroids may still develop elsewhere in the uterus. This distinction is critical, as recurrence often requires careful monitoring, and only a fraction of women experiencing new growth eventually need additional symptom-directed treatment.

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