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Hum. Reprod. Advance Access published online on July 27, 2006

Human Reproduction, doi:10.1093/humrep/del275
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received November 24, 2005
Revised May 3, 2006
Accepted June 14, 2006

Article

Uterine artery embolization for symptomatic fibroids: short-term versus mid-term changes in disease-specific symptoms, quality of life and magnetic resonance imaging results

C. Scheurig 1, A. Gauruder-Burmester 2, C. Kluner 1, R. Kurzeja 3, A. Lembcke 1, E. Zimmermann 1, B. Hamm 1, and T. Kroencke 1 *

1 Department of Radiology, Berlin, Germany
2 Department of Obstetrics and Gynecology, Charité Universitätsmedizin Berlin, Berlin, Germany; Present Address: German Pelvic Floor Centre, Department of Urogynecology, St. Hedwig Hospital, Große Hamburger Str. 5-11, 10115 Berlin, Germany
3 Department of Obstetrics and Gynecology, Charité Universitätsmedizin Berlin, Berlin, Germany

* To whom correspondence should be addressed.
T. Kroencke, E-mail: thomas.kroencke{at}charite.de


   Abstract

BACKGROUND: Prospective study to evaluate changes in symptom severity, health-related quality of life (HRQOL) and uterine and leiomyoma volume after uterine artery embolization (UAE). METHODS: Eighty-two women completed a validated uterine fibroid symptom and quality of life (UFS-QOL) questionnaire and underwent magnetic resonance imaging (MRI) before and 3-20 months after UAE. Primary outcome measures were changes in symptom severity and QOL at short-term follow-up [median 5 (range 3-7) months] and mid-term follow-up [median 14 (8-20) months]. Secondary outcome measures included the frequency of additional procedures to control persistent symptoms and changes in dominant fibroid volume (DFV) and uterine volume (UV). RESULTS: Of 82 patients, 71 (86.6%) patients completed follow-up, 7 (8.5%) patients had a second procedure and 4 (4.9%) were lost to follow-up. Symptom severity scores decreased from a median of 43.75 to 21.88 (P < 0.001) in the short-term follow-up group and from a median of 43.75 to 9.38 (P < 0.001) in the mid-term follow-up group. QOL scores increased from a median of 56.90 to 87.93 (P < 0.001) and 66.81 to 96.12 (P < 0.001), respectively. During short-term follow-up, median UV decreased by 27% (95% CI 20.25-33.81, P < 0.001) and median DFV by 62% (95% CI 47.81-71.55, P < 0.001), whereas UV decreased by 36% (95% CI 23.34-55.02, P < 0.001) and DFV by 66% (95% CI 54.28-71.92, P < 0.001) for the mid-term follow-up group. A decrease in UV correlated with change in symptom severity (P < 0.005). CONCLUSIONS: Women report significant improvements in fibroid-specific symptoms and QOL at short- and mid-term follow-ups after UAE.

Keywords: fibroids/magnetic resonance imaging/quality of life/uterine artery embolization.
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