title: [Change in health-related quality of life and change in clinical symptoms after uterine artery embolization in patients with symptomatic adenomyosis uteri - evaluation using a standardized questionnaire].
abstract: OBJECTIVE
  To evaluate the clinical response of uterine artery embolization (UAE) in women with symptomatic uterine adenomyosis by comparing health-related quality of life and symptom severity before and after UAE using a standardized questionnaire.
  
  
  METHODS
  This longitudinal study at two time points included 17 patients with a median age of 47.1 years with symptomatic uterine adenomyosis (n = 7 pure adenomyosis; n = 10 with concomitant fibroids). The diagnosis was based on clinical symptoms and magnetic resonance imaging (MRI) criteria. Data on health-related quality of life and severity of symptoms before and after UAE were obtained by the standardized "Uterine Fibroid Symptom and Quality of Life" (UFS-QOL) questionnaire and correlated in the following. Treatment failure was defined as the need for a second invasive procedure because of recurrent symptoms or persistent symptoms after UAE.
  
  
  RESULTS
  The median interval between the evaluation of the UFS-QOL questionnaire before and after UAE was 46.0 months. 70.6 % (12/17; 95 % confidence interval 44.0 %  - 88.6 %) of the patients had therapy response with a significant improvement of health-related quality of life and clinical symptoms (p-value = 0.002). The therapy failure rate was 29.4 % (5/17; 95 % confidence interval 11.4 %  - 56.0 %). One patient underwent dilatation and curettage and four patients underwent hysterectomy because of therapy failure.
  
  
  CONCLUSIONS
  UAE to treat symptomatic adenomyosis uteri can significantly improve the health-related quality of life and clinical symptoms. However, therapy failure is possible in up to one-third of patients.
authors.affiliation: Universitätsmedizin Charité Berlin, Radiologie, Berlin. vera.froeling@charite.de
authors.forename: V
authors.initials: V
authors.lastname: Froeling
authors.forename: C
authors.initials: C
authors.lastname: Scheurig-Muenkler
authors.forename: I G
authors.initials: IG
authors.lastname: Steffen
authors.forename: N F
authors.initials: NF
authors.lastname: Schreiter
authors.forename: T J
authors.initials: TJ
authors.lastname: Kröncke
mesh_terms: D000328:Adult; D004621:Embolization, Therapeutic / Q000379:methods*; D004715:Endometriosis / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000098:blood supply / Q000175:diagnosis / Q000628:therapy; D053783:Magnetic Resonance Imaging, Interventional; D008875:Middle Aged; D011594:Psychometrics / Q000706:statistics & numerical data; D011788:Quality of Life; D015203:Reproducibility of Results; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D017211:Treatment Failure; D014591:Uterine Diseases / Q000175:diagnosis / Q000628:therapy*; D014594:Uterine Neoplasms / Q000098:blood supply / Q000175:diagnosis / Q000628:therapy; D014599:Uterus / Q000098:blood supply*