Uterine artery embolization vs hysterectomy in the treatment of symptomatic uterine fibroids: 5-year outcome from the randomized EMMY trial.

Abstract

OBJECTIVE:

The purpose of this study was to compare clinical outcome and health related quality of life (HRQOL) 5 years after uterine artery embolization (UAE) or hysterectomy in the treatment of menorrhagia caused by uterine fibroids.

STUDY DESIGN:

Patients with symptomatic uterine fibroids who were eligible for hysterectomy were assigned randomly 1:1 to hysterectomy or UAE. Endpoints after 5 years were reintervention rates, menorrhagia, and HRQOL measures that were assessed by validated questionnaires.

RESULTS:

Patients were assigned randomly to UAE (n = 88) or hysterectomy (n = 89). Five years after treatment 23 of 81 UAE patients (28.4%) had undergone a hysterectomy because of insufficient improvement of complaints (24.7% after successful UAE). HRQOL measures improved significantly and remained stable until the 5-year follow-up evaluation, with no differences between the groups. UAE had a positive effect both on urinary and defecation function.

CONCLUSION:

UAE is a well-established alternative to hysterectomy about which patients should be counseled.

• Authors: Sanne M van der Kooij, Wouter J K Hehenkamp, Nicole A Volkers, Erwin Birnie, Willem M Ankum, Jim A Reekers
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 203 Issue 2 Pg. 105.e1-13 (Aug 2010) ISSN: 1097-6868 [Electronic] United States
• PMID: 20579960 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright (c) 2010. Published by Mosby, Inc.

Topics

• Adult
• Female
• Follow-Up Studies
• Humans
• Hysterectomy (adverse effects, methods)
• Hysterectomy, Vaginal (adverse effects, methods)
• Kaplan-Meier Estimate
• Leiomyoma (pathology, surgery)
• Middle Aged
• Neoplasm Staging
• Pain Measurement
• Pain, Postoperative (physiopathology)
• Patient Satisfaction
• Postoperative Complications (epidemiology, physiopathology)
• Prospective Studies
• Quality of Life
• Risk Assessment
• Statistics, Nonparametric
• Time Factors
• Treatment Outcome
• Uterine Artery Embolization (adverse effects, methods)
• Uterine Neoplasms (pathology, surgery)