Outcome of uterine embolization and hysterectomy for leiomyomas: results of a multicenter study.
OBJECTIVE
The purpose of this study was to estimate the outcomes of uterine embolization and hysterectomy for uterine leiomyomas. Study design This was a multicenter prospective study of patients who were treated with embolization (n=102 patients) and hysterectomy (n=50 patients) for leiomyomas. Changes in symptoms, complications, and quality of life were measured. The data analysis included linear and logistic regression, the Student t and paired t test, Fisher's exact test, and chi-squared test.


RESULTS
For patients who underwent embolization, there were marked reductions in blood loss scores (P <.001) and menorrhagia questionnaire scores (P <.001) compared with baseline. At 12 months, a larger proportion of the patients who had undergone hysterectomy experienced improved pelvic pain (P=.021). Both groups had marked improvement in other symptoms and quality of life scores, with no difference between groups. Complications were more frequent in patients who underwent hysterectomy (50% vs 27.5%; P=.01).


CONCLUSIONS
Both procedures substantially improved symptoms for most patients, with an advantage for hysterectomy at 12 months for pelvic pain. Serious complications were infrequent in both groups.
Georgetown University Hospital, Washington DC, USA. spiesj@gunet.georgetown.edu
James B
JB
Spies
Jay M
JM
Cooper
Robert
R
Worthington-Kirsch
John C
JC
Lipman
Benjie B
BB
Mills
James F
JF
Benenati
D000328:Adult; D001158:Arteries; D004621:Embolization, Therapeutic / Q000009:adverse effects; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D007889:Leiomyoma / Q000098:blood supply / Q000601:surgery / Q000628:therapy*; D016015:Logistic Models; D008863:Microspheres; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000098:blood supply / Q000601:surgery / Q000628:therapy*; D014599:Uterus / Q000098:blood supply