title: Tolerance, hospital stay, and recovery after uterine artery embolization for fibroids: the Ontario Uterine Fibroid Embolization Trial.
abstract: OBJECTIVE
  Uterine artery embolization (UAE) is gaining popularity as an alternative to hysterectomy for the treatment of fibroids. Although minimally invasive treatments such as UAE offer the potential of fewer complications, shorter hospital stay, and quicker recovery than surgery, there have been few published data on tolerance and recovery in patients undergoing UAE.
  
  
  METHODS
  This was a multicenter prospective single-arm clinical treatment trial involving the practices of 11 interventional radiologists in eight Ontario university-affiliated and community hospitals. Between November 1998 and November 2000, 555 women underwent UAE for symptomatic uterine fibroids. Follow-up included ultrasound examinations and telephone interviews. UAE was performed under conscious sedation. Polyvinyl alcohol particles (355-500 micro m) were the primary embolic agent, and the procedural endpoint involved stasis in the uterine arteries. Pain protocols included antiinflammatory medications and narcotics and a planned overnight hospital admission. Tolerance and recovery were measured by patient-reported pain intensity (10-point numeric rating and five-point descriptor scale), hospital length of stay (LOS), and time until return to work.
  
  
  RESULTS
  Intraprocedural pain was reported by 30% of patients and postprocedural pain was reported by 92% of patients (mean pain rating +/- SD, 7.0 +/- 2.47). The mean hospital LOS was 1.3 nights. Postprocedural pain was the most common indication for an LOS greater than 1 night (18%) or 2 nights (5%). Return visits to the hospital (10%) and readmissions (3%) were primarily for pain. The overall postprocedural complication rate was 8.0% (95% CI: 5.9%-10.6%). Of the 44 complications, 32 (73%) were pain-related. The mean recovery time after UAE was 13.1 days (median, 10.0 d).
  
  
  CONCLUSIONS
  The majority of patients had a 1-night LOS after UAE and recovered within 2 weeks. Postprocedural pain varied considerably and was the major indication for extended hospital stay and recovery.
authors.affiliation: Department of Public Health Sciences, University of Toronto, Ontario, Canada. g.pron@utoronto.ca
authors.forename: Gaylene
authors.initials: G
authors.lastname: Pron
authors.forename: Eva
authors.initials: E
authors.lastname: Mocarski
authors.forename: John
authors.initials: J
authors.lastname: Bennett
authors.forename: George
authors.initials: G
authors.lastname: Vilos
authors.forename: Andrew
authors.initials: A
authors.lastname: Common
authors.forename: Mukarram
authors.initials: M
authors.lastname: Zaidi
authors.forename: Kenneth
authors.initials: K
authors.lastname: Sniderman
authors.forename: Murray
authors.initials: M
authors.lastname: Asch
authors.forename: Roman
authors.initials: R
authors.lastname: Kozak
authors.forename: Martin
authors.initials: M
authors.lastname: Simons
authors.forename: Cuong
authors.initials: C
authors.lastname: Tran
authors.forename: John
authors.initials: J
authors.lastname: Kachura
mesh_terms: D000293:Adolescent; D000328:Adult; D003289:Convalescence; D004621:Embolization, Therapeutic / Q000009:adverse effects; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000098:blood supply / Q000628:therapy*; D007902:Length of Stay; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D010147:Pain Measurement; D010359:Patient Readmission; D011446:Prospective Studies; D014594:Uterine Neoplasms / Q000098:blood supply / Q000628:therapy*; D014599:Uterus / Q000098:blood supply*