The effect of uterine fibroid embolization on lower urinary tract symptoms
Introduction and hypothesis
The objective was to determine the effect of uterine fibroid embolization (UFE) on lower urinary tract symptoms (LUTS) and quality of life (QoL).
This prospective study included women with symptomatic fibroids and LUTS who underwent UFE between March 2008 and May 2010. Subjects underwent pre-procedural pelvic magnetic resonance imaging (MRI) and completed the Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7), Prolapse and Incontinence Sexual Questionnaire (PISQ-12), Uterine Fibroid Symptom Quality of Life questionnaire (UFS-QoL), and a standardized 48-h bladder diary at baseline and 3 months after the procedure. Patient Global Impression of Improvement (PGI-I) assessed post-procedural patient satisfaction. The primary outcome was subjective improvement in LUTS at 3 months, as measured by a decrease in UDI-6 score. Univariate analysis, paired t test and a stepwise regression analysis were appropriately conducted.
Fifty-seven patients underwent UFE and completed bladder diaries and questionnaires. At 3 months after UFE, patients reported a significant decrease in UDI-6, IIQ-7, and UFS-QoL, indicating an improvement in urinary symptoms and QoL. Bladder diaries showed a significant reduction in daytime and night-time voids. No difference was found in incontinence episodes. Uterine volume, dominant fibroid size, fibroid location, and MRI-confirmed bladder compression did not affect the difference in UDI-6 scores. In a stepwise regression model, BMI had a significant impact on the change in UDI-6 score, with a decrease of 1.18 points for each 1 unit increase in BMI.
Uterine fibroid embolization significantly improves LUTS and urinary-related QoL. Obesity seems to attenuate this effect.
KeywordsUterine fibroid embolization Lower urinary tract symptoms Sexual function Quality of life
The authors would like to acknowledge Jaime Lee, CRNP, and Michelle M. Jones, CRNP, for their unique and critical contribution to this study. This study was supported by a grant from the MedStar Health Research Institute Graduate Medical Education.
Conflicts of interest
- 4.Pron G, Cohen M, Soucie J, Garvin G, Vanderburgh L, Bell S, Ontario Uterine Fibroid Embolization Collaboration Group (2003) The Ontario Uterine Fibroid Embolization Trial. I. Baseline patient characteristics, fibroid burden, and impact on life. Fertil Steril 79(1):112–119PubMedCrossRefGoogle Scholar
- 5.Learman LA, Summitt RL Jr, Varner RE, McNeeley SG, Goodman-Gruen D, Richter HE, Lin F, Showstack J, Ireland CC, Vittinghoff E, Hulley SB, Washington AE, Total or Supracervical Hysterectomy (TOSH) Research Group (2003) A randomized comparison of total or supracervical hysterectomy: surgical complications and clinical outcomes. Obstet Gynecol 102(3):453–462PubMedCrossRefGoogle Scholar
- 6.Pron G, Bennett J, Common A, Wall J, Asch M, Sniderman K, Ontario Uterine Fibroid Embolization Collaboration Group (2003) The Ontario Uterine Fibroid Embolization Trial. II. Uterine fibroid reduction and symptom relief after uterine artery embolization for fibroids. Fertil Steril 79(1):120–127PubMedCrossRefGoogle Scholar