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The effect of uterine fibroid embolization on lower urinary tract symptoms

International Urogynecology Journal volume 24, pages 1341–1345 (2013)Cite this article

An Erratum to this article was published on 02 August 2013

Abstract

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).

Methods

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.

Results

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.

Conclusion

Uterine fibroid embolization significantly improves LUTS and urinary-related QoL. Obesity seems to attenuate this effect.

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References

  1. Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM (2003) High cumulative incidence of uterine leiomyoma on black and white women: ultrasound evidence. Am J Obstet Gynecol 188:100–107

    PubMed  Article  Google Scholar 

  2. Wallach EE, Vlahos NF (2004) Uterine myomas: an overview of development, clinical features, and management. Obstet Gynecol 104:393–406

    PubMed  Article  Google Scholar 

  3. Flynn M, Jamison M, Datta S, Myers E (2006) Health care resource use for uterine fibroid tumors in the United States. Am J Obstet Gynecol 195:955–964

    PubMed  Article  Google Scholar 

  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):112–119

    PubMed  Article  Google 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):453–462

    PubMed  Article  Google 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):120–127

    PubMed  Article  Google Scholar 

  7. Spies JB, Cornell C, Wothington-Kirsch R, Lipman J, Benenati JF (2007) Long-term outcome from uterine fibroid embolization with tris-acryl gelatin microspheres: results of a multicenter study. J Vasc Interv Radiol 18:203–207

    PubMed  Article  Google Scholar 

  8. Bucek RA, Puchner S, Lammer J (2006) Mid- and long-term quality-of-life assessment in patients undergoing uterine fibroid embolization. AJR Am J Roentgenol 186(3):877–882

    PubMed  Article  Google Scholar 

  9. Spies JB, Cooper JM, Worthington-Kirsch R, Lipman J, Mills BB, Benenati JF (2004) Outcome of uterine embolization and hysterectomy for leiomyomas: results of a multicenter study. Am J Obstet Gynecol 191:22–31

    PubMed  Article  Google Scholar 

  10. Goodwin SC, Spies JB, Worthington-Kirsch R, Peterson E, Pron G, Li S et al (2008) Uterine artery embolization for treatment of leiomyomata long-term outcomes from the FIBROID Registry. Obstet Gynecol 111(1):22–33

    PubMed  Article  Google Scholar 

  11. Barber MD, Walters MD, Bump RC (2005) Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol 193:103–113

    PubMed  Article  CAS  Google Scholar 

  12. Rogers R, Kammerer-Doak D, Villarreal A, Coates K, Qualls C (2001) A new instrument to measure sexual function in women with urinary incontinence or pelvic organ prolapse. Am J Obstet Gynecol 184:552–558

    PubMed  Article  CAS  Google Scholar 

  13. Spies JB, Coyne K, Guaou Guaou N, Boyle D, Skyrnarz-Murphy K, Gonzalves SM (2002) The UFS-QOL, a new disease-specific symptom and health-related quality of life questionnaire for leiomyomata. Obstet Gynecol 99(2):290–300

    PubMed  Article  Google Scholar 

  14. Harding G, Coyne KS, Thompson CL, Spies JB (2008) The responsiveness of the uterine fibroid symptom and health-related quality of life questionnaire (UFS-QOL). Health Qual Life Outcomes 6:99

    PubMed  Article  Google Scholar 

  15. Barber MD, Spino C, Janz NK, Brubaker L, Nygaard I, Nager CW, Wheeler TL (2009) The minimum important differences for the urinary scales of the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire. Am J Obstet Gynecol 200(5):580.e1–580.e7

    Article  Google Scholar 

  16. Urwitz-Lane R, Ozel B (2006) Sexual function in women with urodynamic stress incontinence, detrusor overactivity, and mixed urinary incontinence. Am J Obstet Gynecol 195(6):1758–1761

    PubMed  Article  Google Scholar 

  17. Aschkenazi SO, Rogers RG, Beaumont J, Botros SM, Sand PK, Goldberg RP (2010) A valid form of the PISQ-12, the PISQ-9, for use in comparative studies of women with and without pelvic organ prolapse and/or urinary incontinence. Female Pelvic Med Reconstr Surg 16(4):218–223

    PubMed  Article  Google Scholar 

  18. Arleo EK, Tal MG (2008) Fibroid-induced acute urinary retention: treatment by uterine artery embolization. Int Urogynecol J Pelvic Floor Dysfunct 19(1):161–165

    PubMed  Google Scholar 

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Acknowledgements

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

None.

Author information

Affiliations

  1. Department of Obstetrics & Gynecology, Hadassah—Hebrew University Medical Center, Ein Kerem, PO Box 12000, Jerusalem, Israel

    David Shveiky

  2. Section of Female Pelvic Medicine and Reconstructive Surgery, MedStar Washington Hospital Center, Washington, DC, USA

    Cheryl B. Iglesia, Danielle D. Antosh, Bela I. Kudish & Joanna Peterson

  3. Department of Obstetrics & Gynecology and Urology, Washington Hospital Center/Georgetown University, Washington, DC, USA

    Cheryl B. Iglesia, Danielle D. Antosh, Bela I. Kudish & Joanna Peterson

  4. Department of Radiology, Georgetown University School of Medicine, Washington, DC, USA

    James B. Spies

  5. Department of Biostatistics and Epidemiology, Medstar Research Institute, Washington, DC, USA

    Chun-Chin Huang

Authors
  1. David Shveiky
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  2. Cheryl B. Iglesia
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  3. Danielle D. Antosh
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  4. Bela I. Kudish
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  5. Joanna Peterson
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  6. Chun-Chin Huang
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  7. James B. Spies
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Correspondence to David Shveiky.

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Shveiky, D., Iglesia, C.B., Antosh, D.D. et al. The effect of uterine fibroid embolization on lower urinary tract symptoms. Int Urogynecol J 24, 1341–1345 (2013). https://doi.org/10.1007/s00192-012-2013-7

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  • DOI: https://doi.org/10.1007/s00192-012-2013-7

Keywords

  • Uterine fibroid embolization
  • Lower urinary tract symptoms
  • Sexual function
  • Quality of life