Uterine Artery Embolization versus Myomectomy: Impact on Quality of Life—Results of the FUME (Fibroids of the Uterus: Myomectomy versus Embolization) Trial
- 1.4k Downloads
This study was designed to compare quality of life (QoL) outcomes after uterine artery embolization (UAE) or myomectomy.
Women with symptomatic fibroids diagnosed by ultrasound who wished to preserve their uterus were randomized to myomectomy (n = 81) or UAE (n = 82). Endpoints at 1 year were QoL measured by a validated questionnaire, hospital stay, rates of complications, and need for reintervention.
UAE patients had shorter hospitalization (2 vs. 6 days, p < 0.001). By 1 year postintervention, significant and equal improvements in QoL scores had occurred in both groups (myomectomy n = 59; UAE n = 61). There had been two (2.9%) major complications among UAE versus 6 (8%) among myomectomy patients (not significant). By 2 years, among UAE patients (n = 57) there were eight (14.0%) reinterventions for inadequate symptom control compared with one (2.7%) among myomectomy patients (n = 37). Half of the women who required hysterectomy had concomitant adenomyosis missed by US.
UAE and myomectomy both result in significant and equal improvements in QoL. UAE allows a shorter hospital stay and fewer major complications but with a higher rate of reintervention.
KeywordsFibroid Myomectomy Quality of life Uterine artery embolization
This study did not receive official funding but was supported by soft funds. The authors thank all the women who participated in this trial.
Conflict of interest
- 3.Office of National Statistics (2009) Birth statistics. Report no.: Series FM1 no. 37. London: Office of National StatisticsGoogle Scholar
- 12.Siskin GP, Shlansky-Goldberg RD, Goodwin SC et al (2006) A prospective multicenter comparative study between myomectomy and uterine artery embolization with polyvinyl alcohol microspheres: long-term clinical outcomes in patients with symptomatic uterine fibroids. J Vasc Interv Radiol 17:1287–1295PubMedCrossRefGoogle Scholar
- 13.Hirst A, Dutton S, Wu O, Briggs A, Edwards C, Waldenmaier L, Maresh M, Nicholson A, McPherson K (2008) A multi-centre retrospective cohort study comparing the efficacy, safety and cost-effectiveness of hysterectomy and uterine artery embolisation for the treatment of symptomatic uterine fibroids. (HOPEFUL) Health Technol Assess 12(5):1–248PubMedGoogle Scholar
- 21.Moss JG, Cooper KG, Khaund A et al (2011) Randomized comparison of uterine artery embolization (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST trial):5-year results. BJOG. doi: 10.1111/j.1471-0528
- 30.Griffiths A, D’Angelo A, Amso N (2006) Surgical treatment of fibroids for subfertility. Cochrane Database Syst Rev 3:CD003857Google Scholar