Blender add-on: Symmetrize Uv Util – Axis setup

You need not set up anything, except that the mirror axis of either your UV map or mesh is not X but Y.

Case 1. Both UV and mesh are mirrored along X axis (Default)

Case 2. Both UV and mesh are mirrored along Y axis

Case 3. UV is mirrored along X axis, but mesh is mirrored along Y axis