Nicole Aimee Volkers MD, Presenter: Nothing to Disclose

Wouter J.K. Hehenkamp MD, Abstract Co-Author: Nothing to Disclose

Erwin Birnie, Abstract Co-Author: Nothing to Disclose

Willem M. Ankum MD,PhD, Abstract Co-Author: Nothing to Disclose

Jim A. Reekers MD, PhD, Abstract Co-Author: Nothing to Disclose

To compare uterine artery embolization (UAE) and hysterectomy in the treatment of symptomatic uterine fibroids. Outcome measures: cessation of menorrhagia, secondary procedures, volume reduction, pain, bulk-related complaints, quality of life (QOL) and satisfaction after a follow up period of 2 years.

Between 2002 and 2004 177 patients with menorrhagia due to uterine fibroids were randomly assigned to UAE (n=88) or hysterectomy (n=89). UAE was performed using PVA particles. Hysterectomies were performed vaginally or abdominally. Secondary procedures were noted. Uterine and dominant fibroid volumes were assessed by ultrasound in the UAE group. Pain and bulk-related complaints were scored on a 5-point Likert scale. QOL was scored using the SF-36 questionnaire, both the mental (MCS) and the physical (PCS) component summary. Satisfaction was measured using a 7-point Likert scale.

At 2 years 19/81 (23.5%) of UAE patients had undergone a secondary hysterectomy for unsatisfactory results. Uterine and fibroid volumes decreased by 48.2% and 60.5%, respectively (UAE group). Improvement in pain was reported in 85% of UAE patients and 78% hysterectomy patients (p=0.30), while bulk-related complaints improved in 66% of UAE- and 69% of hysterectomy patients (p=0.71). QOL improved significantly compared to baseline, and did not differ between both groups (MCS: p=0.50; PCS: p=0.95). Satisfaction was higher in hysterectomy patients at 2 years.

Hysterectomy was avoided in 76.5% of UAE patients. QOL, pain and bulk-related complaints improved equally and significantly in both groups. At 2 years hysterectomy patients were more satisfied.

To compare uterine artery embolization and hysterectomy in a randomized trial with regard to clinical outcome, quality of life and satisfaction.

Volkers, N, Hehenkamp, W, Birnie, E, Ankum, W, Reekers, J, Uterine Artery Embolization versus Hysterectomy in the Treatment of Uterine Fibroids: A Randomized Comparison of Clinical Outcome, Quality of Life and Satisfaction at 2 Years Follow-up.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4433452.html