Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids: 2 years' outcome from the randomized EMMY trial.
OBJECTIVE
The purpose of this study was to compare the 2 years' efficiency of uterine artery embolization (UAE) with hysterectomy in the treatment of menorrhagia caused by uterine fibroids in a randomized controlled trial.


METHODS
Twenty-eight Dutch hospitals recruited patients with uterine fibroids and menorrhagia, who were eligible for hysterectomy. Patients were randomized to UAE or hysterectomy. The primary endpoint was if UAE could avoid a subsequent hysterectomy in at least 75% of cases. Secondary endpoints were changes in pain, bulk-related complaints, and uterine and dominant fibroid volume reduction.


RESULTS
One hundred seventy-seven patients were randomized to UAE (n = 88) or hysterectomy (n = 89). Two years after treatment 23.5% of UAE patients had undergone a hysterectomy. There were no significant differences in improvement compared to baseline in pain and bulk-related complaints. Uterine and dominant fibroid volume reduction in UAE patients was 48.2% and 60.5%, respectively.


CONCLUSIONS
UAE is a valuable alternative treatment for symptomatic uterine fibroids. Nevertheless, when patients seek for certainty on the cessation of bleeding problems, a hysterectomy remains the treatment of choice.
Volkers
Nicole A
NA
Department of Radiology, Academic Medical Centre, Amsterdam, The Netherlands. n.a.volkers@amc.uva.nl
Hehenkamp
Wouter J K
WJ
Birnie
Erwin
E
Ankum
Willem M
WM
Reekers
Jim A
JA
D015746:Abdominal Pain / Q000628:therapy; D000328:Adult; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D018231:Leiomyomatosis / Q000098:blood supply / Q000150:complications / Q000473:pathology / Q000628:therapy*; D008595:Menorrhagia / Q000209:etiology / Q000628:therapy*; D008875:Middle Aged; D010298:Parity; D011247:Pregnancy; D011446:Prospective Studies; D012044:Regression Analysis; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000098:blood supply / Q000150:complications / Q000473:pathology / Q000628:therapy*; D014599:Uterus / Q000098:blood supply