title: The effect of uterine fibroid embolization on lower urinary tract symptoms.
abstract: OBJECTIVE
  The objective was to determine the effect of uterine fibroid embolization (UFE) on lower urinary tract symptoms (LUTS) and quality of life (QoL).
  
  
  METHODS
  This prospective study included women with symptomatic fibroids and LUTS who underwent UFE between March 2008 and May 2010. Subjects underwent pre-procedural pelvic magnetic resonance imaging (MRI) and completed the Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7), Prolapse and Incontinence Sexual Questionnaire (PISQ-12), Uterine Fibroid Symptom Quality of Life questionnaire (UFS-QoL), and a standardized 48-h bladder diary at baseline and 3 months after the procedure. Patient Global Impression of Improvement (PGI-I) assessed post-procedural patient satisfaction. The primary outcome was subjective improvement in LUTS at 3 months, as measured by a decrease in UDI-6 score. Univariate analysis, paired t test and a stepwise regression analysis were appropriately conducted.
  
  
  RESULTS
  Fifty-seven patients underwent UFE and completed bladder diaries and questionnaires. At 3 months after UFE, patients reported a significant decrease in UDI-6, IIQ-7, and UFS-QoL, indicating an improvement in urinary symptoms and QoL. Bladder diaries showed a significant reduction in daytime and night-time voids. No difference was found in incontinence episodes. Uterine volume, dominant fibroid size, fibroid location, and MRI-confirmed bladder compression did not affect the difference in UDI-6 scores. In a stepwise regression model, BMI had a significant impact on the change in UDI-6 score, with a decrease of 1.18 points for each 1 unit increase in BMI.
  
  
  CONCLUSIONS
  Uterine fibroid embolization significantly improves LUTS and urinary-related QoL. Obesity seems to attenuate this effect.
authors.affiliation: Department of Obstetrics & Gynecology, Hadassah-Hebrew University Medical Center, Ein Kerem, PO Box 12000, Jerusalem, Israel. dshveiky@gmail.com
authors.forename: David
authors.initials: D
authors.lastname: Shveiky
authors.forename: Cheryl B
authors.initials: CB
authors.lastname: Iglesia
authors.forename: Danielle D
authors.initials: DD
authors.lastname: Antosh
authors.forename: Bela I
authors.initials: BI
authors.lastname: Kudish
authors.forename: Joanna
authors.initials: J
authors.lastname: Peterson
authors.forename: Chun-Chih
authors.initials: CC
authors.lastname: Huang
authors.forename: Chun-Chin
authors.initials: CC
authors.lastname: Huang
authors.forename: James B
authors.initials: JB
authors.lastname: Spies
mesh_terms: D015992:Body Mass Index; D015897:Comorbidity; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D007889:Leiomyoma / Q000453:epidemiology* / Q000628:therapy*; D059411:Lower Urinary Tract Symptoms / Q000453:epidemiology* / Q000628:therapy*; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011446:Prospective Studies; D011788:Quality of Life; D012044:Regression Analysis; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome