Literature DB >> 18187401

Symptomatic uterine fibroids: treatment with uterine artery embolization or hysterectomy--results from the randomized clinical Embolisation versus Hysterectomy (EMMY) Trial.

Wouter J K Hehenkamp1, Nicole A Volkers, Erwin Birnie, Jim A Reekers, Willem M Ankum.   

Abstract

PURPOSE: To prospectively evaluate health-related quality of life (HRQOL) outcomes for uterine artery embolization (UAE) and hysterectomy up to 24 months after the intervention in terms of mental and physical health, urinary and defecatory function, and overall patient satisfaction.
MATERIALS AND METHODS: Ethics committee approval and informed consent were obtained for the Embolisation versus Hysterectomy Trial. Women (n = 177) with uterine fibroids and heavy menstrual bleeding who were scheduled to undergo hysterectomy were randomly assigned to undergo UAE (n = 88) or hysterectomy (n = 89). HRQOL was measured six times during a 24-month follow-up period with the following validated questionnaires: Medical Outcome Study Short Form 36 (SF-36) mental component summary (MCS) and physical component summary (PCS), Health Utilities Index Mark 3, EuroQol 5D, urogenital distress inventory (UDI), incontinence impact questionnaire, and defecation distress inventory (DDI). Satisfaction was assessed with a seven-point Likert scale. Repeated measurement analysis was performed for between-group analysis. Paired t tests were performed for within-group analysis. Satisfaction was analyzed with the Fisher exact test.
RESULTS: The SF-36 MCS and PCS, Health Utilities Index Mark 3, EuroQol 5D, and UDI scores were improved significantly in both groups at 6 months and afterward (P < .05). The DDI score was improved significantly in only the UAE group at 6 months and afterward (P < .05). No differences between groups were observed, with the exception of PCS scores at 6-week follow-up: Patients in the UAE group had significantly better scores than did patients in the hysterectomy group (P < .001). Improvement in PCS score at 24-month follow-up was significantly higher for patients who were employed at baseline (P = .035). At 24-month follow-up, patients in the hysterectomy group were significantly more satisfied than those in the UAE group (P = .02).
CONCLUSION: Both UAE and hysterectomy improved HRQOL. No differences were observed between groups regarding HRQOL at 24-month follow-up. On the basis of HRQOL results, the authors determined that UAE is a good alternative to hysterectomy. (c) RSNA, 2008.

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Year:  2008        PMID: 18187401     DOI: 10.1148/radiol.2463070260

Source DB:  PubMed          Journal:  Radiology        ISSN: 0033-8419            Impact factor:   11.105


  26 in total

1.  Uterine artery embolisation versus hysterectomy for leiomyomas: primary and 2-year follow-up results of a randomised prospective clinical trial.

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Journal:  Eur Radiol       Date:  2010-06-06       Impact factor: 5.315

2.  Three-Dimensional Quantitative Assessment of Uterine Fibroid Response after Uterine Artery Embolization Using Contrast-Enhanced MR Imaging.

Authors:  Julius Chapiro; Rafael Duran; MingDe Lin; John D Werner; Zhijun Wang; Rüdiger Schernthaner; Lynn Jeanette Savic; Mark L Lessne; Jean-François Geschwind; Kelvin Hong
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Review 3.  Current evidence on uterine embolization for fibroids.

Authors:  James B Spies
Journal:  Semin Intervent Radiol       Date:  2013-12       Impact factor: 1.513

4.  Uterine artery embolization by use of porous gelatin particles for symptomatic uterine leiomyomas: comparison with hand-cut gelatin sponge particles.

Authors:  Yuichiro Izumi; Shuji Ikeda; Akira Kitagawa; Eisuke Katsuda; Makiyo Hagihara; Seiji Kamei; Toyohiro Ota; Tsuneo Ishiguchi
Journal:  Jpn J Radiol       Date:  2015-06-23       Impact factor: 2.374

5.  Can measurement of apparent diffusion coefficient before treatment predict the response to uterine artery embolization for adenomyosis?

Authors:  Yaewon Park; Man Deuk Kim; Dae Chul Jung; Shin Jae Lee; Gyoungmin Kim; Sung Il Park; Jong Yun Won; Do Yun Lee
Journal:  Eur Radiol       Date:  2014-12-07       Impact factor: 5.315

6.  Advances in the management of uterine fibroids.

Authors:  Kirsty I Munro; Hilary Od Critchley
Journal:  F1000 Med Rep       Date:  2009-09-28

7.  Hysterectomy or a minimal invasive alternative? A systematic review on quality of life and satisfaction.

Authors:  H A M Brölmann; A J Bijdevaate; A Vonk Noordegraaf; P F Janssen; J A F Huirne
Journal:  Gynecol Surg       Date:  2010-05-22

8.  Recruitment and retention of women for clinical leiomyoma trials.

Authors:  Desireé McCarthy-Keith; Sahadat Nurudeen; Alicia Armstrong; Eric Levens; Lynnette K Nieman
Journal:  Contemp Clin Trials       Date:  2009-09-27       Impact factor: 2.226

9.  Characteristics of vascular supply to uterine leiomyoma: an analysis of digital subtraction angiography imaging in 518 cases.

Authors:  Chun-Lin Chen; Yu-Jing Xu; Ping Liu; Jiang-Hong Zhu; Ben Ma; Bei-Lan Zeng; Yan Zhou; Li Wang; Yi-Xin Tang; Chuan-Jia Guo
Journal:  Eur Radiol       Date:  2012-09-22       Impact factor: 5.315

10.  The relationship between uterine leiomyomata and pelvic floor symptoms.

Authors:  Christina E Dancz; Priyanka Kadam; Carrie Li; Kristen Nagata; Begüm Özel
Journal:  Int Urogynecol J       Date:  2013-08-07       Impact factor: 2.894

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