Uterine fibroid embolization versus myomectomy in women wishing to preserve fertility: preliminary results of a randomized controlled trial.
OBJECTIVE
To compare the clinical results of surgical and endovascular treatment of uterine myomas in young women.


METHODS
In a university-affiliated, tertiary care center a prospective trial was conducted. Sixty-three women, wishing to retain fertility, with intramural fibroid(s) larger than 4 cm, were randomly selected either for uterine artery embolization or myomectomy. Invasiveness, efficacy, and complications of both procedures were compared.


RESULTS
Thirty embolizations and 33 myomectomies (15 laparoscopic, 18 open) were performed. The mean follow-up was 17 months. In embolized patients, there was a significantly shorter procedure length (p<0.0001), hospital stay (p<0.001) and disability period (p<0.0001), lower CRP (p<0.001) and higher hemoglobin (p<0.0001) concentrations the 2nd day after procedure. But there was a higher incidence of re-interventions (p<0.01) and a lower rate of total symptomatic relief (p<0.1). The groups did not significantly differ in: technical success rate, febrile morbidity, FSH levels 6 months after the procedure, and complication rates.


CONCLUSIONS
Although the reproductive outcomes of uterine artery embolization and myomectomy cannot be evaluated at the moment, our first results indicate that both methods are clinically successful in the majority of cases and are not connected with significant number of serious complications.
Mara
Michal
M
Department of Obstetrics and Gynecology, Division of Minimally Invasive Surgery, General Faculty Hospital and 1st Medical Faculty of Charles University, Apolinarska 18, 128 00, Prague 2, Czech Republic. michal.mara@quick.cz
Fucikova
Zuzana
Z
Maskova
Jana
J
Kuzel
David
D
Haakova
Lucia
L
D000328:Adult; D018153:Czech Republic; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005298:Fertility; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D007902:Length of Stay; D009215:Myometrium / Q000601:surgery; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D014599:Uterus / Q000098:blood supply