Uterine artery embolization versus abdominal myomectomy: a long-term clinical outcome comparison.
OBJECTIVE
To assess long-term clinical effectiveness of uterine artery embolization (UAE) compared with abdominal myomectomy.


METHODS
Women who received UAE (n = 87) or abdominal myomectomy (n = 98) for symptomatic uterine leiomyomata between 2000 and 2002 at a single institution were consecutively enrolled in this study. Patients whose procedures were performed within 5 years before the study were included. Symptom evaluations with symptom severity scores, pregnancy rates, and satisfaction with the procedures were obtained via institutional review board-approved questionnaires. Chart reviews were performed to supplement analyses.


RESULTS
The retrospective cohort included 185 patients, of whom long-term follow-up was completed by 89 patients (48.1%), 48 being treated with UAE, and 41 with myomectomy. Follow-up ranged from 50 to 83 months. A higher but not statistically significant number of patients received repeat interventions after abdominal myomectomy (14%) versus UAE (8%; P = .204). Significantly higher symptom severity score improvements were seen in patients treated with UAE versus abdominal myomectomy (34 vs 31; P = .02). UAE recipients were less likely to attempt to get pregnant (P = .02), but those who did had a 66.7% success rate compared with 58.8% for patients who underwent myomectomy. Similar numbers of patients between groups were satisfied with the procedure (P = .57), reported effectiveness of symptom relief (P = .43), and would recommend the procedure to others (P = .37).


CONCLUSIONS
UAE results in long-term clinical success with outcomes comparable or superior to those of abdominal myomectomy.
Narayan
Anand
A
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Lee
Adrea S
AS
Kuo
George P
GP
Powe
Neil
N
Kim
Hyun S
HS
D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data*; D006801:Humans; D007889:Leiomyoma / Q000453:epidemiology* / Q000628:therapy*; D008137:Longitudinal Studies; D008396:Maryland / Q000453:epidemiology; D009215:Myometrium / Q000601:surgery*; D011247:Pregnancy; D018873:Pregnancy Rate; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000706:statistics & numerical data*; D014594:Uterine Neoplasms / Q000453:epidemiology* / Q000628:therapy*