title: Uterine artery embolization versus laparoscopic uterine artery occlusion: the outcomes of a prospective, nonrandomized clinical trial.
abstract: OBJECTIVE
  To compare outcomes of two different types of occlusive therapy of uterine fibroids.
  
  
  METHODS
  Women with fibroid(s) unsuitable for laparoscopic myomectomy (LM) were treated with uterine artery embolization (UAE) or laparoscopic uterine artery occlusion (LUAO).
  
  
  RESULTS
  Before the procedure, patients treated with UAE (n = 100) had a dominant fibroid greater in size (68 vs. 48 mm) and a mean age lower (33.1 vs. 34.9 years) than surgically treated patients (n = 100). After 6 months, mean shrinkage of fibroid volume was 53 % after UAE and 39 % after LUAO (p = 0.063); 82 % of women after UAE, but only 23 % after LUAO, had complete myoma infarction (p = 0.001). Women treated with UAE had more complications (31 vs. 11 cases, p = 0.006) and greater incidence of hysteroscopically verified intrauterine necrosis (31 vs. 3 %, p = 0.001). Both groups were comparable in markers of ovarian functions and number of nonelective reinterventions. The groups did not differ in pregnancy (69 % after UAE vs. 67 % after LUAO), delivery (50 vs. 46 %), or abortion (34 vs. 33 %) rates. The mean birth weight of neonates was greater (3270 vs. 2768 g, p = 0.013) and the incidence of intrauterine growth restriction lower (13 vs. 38 %, p = 0.046) in post-UAE patients.
  
  
  CONCLUSIONS
  Both methods are effective in the treatment of women with future reproductive plans and fibroids not suitable for LM. UAE is more effective in causing complete ischemia of fibroids, but it is associated with greater risk of intrauterine necrosis. Both methods have low rate of serious complications (except for a high abortion rate).
authors.affiliation: Department of Obstetrics and Gynecology, 1st Medical Faculty of Charles University, Prague 2, Czech Republic.
authors.forename: Michal
authors.initials: M
authors.lastname: Mara
authors.forename: Kristyna
authors.initials: K
authors.lastname: Kubinova
authors.forename: Jana
authors.initials: J
authors.lastname: Maskova
authors.forename: Petr
authors.initials: P
authors.lastname: Horak
authors.forename: Tomas
authors.initials: T
authors.lastname: Belsan
authors.forename: David
authors.initials: D
authors.lastname: Kuzel
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003287:Contrast Media; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D010535:Laparoscopy / Q000379:methods*; D007889:Leiomyoma / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D011183:Postoperative Complications; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000379:methods*; D014594:Uterine Neoplasms / Q000628:therapy*
chemical_list: D003287:Contrast Media