American Journal of Obstetrics & Gynecology
Volume 203, Issue 2 , Pages 105.e1-105.e13, August 2010

Uterine artery embolization vs hysterectomy in the treatment of symptomatic uterine fibroids: 5-year outcome from the randomized EMMY trial

  • Sanne M. van der Kooij, MD

      Affiliations

    • Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
    • Department of Gynecology, Academic Medical Center, Amsterdam, The Netherlands
    • Corresponding Author InformationReprints: Sanne M. van der Kooij, MD, Academic Medical Center, Department of Gynecology, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
  • ,
  • Wouter J.K. Hehenkamp, MD, PhD

      Affiliations

    • Department of Gynecology, Academic Medical Center, Amsterdam, The Netherlands
  • ,
  • Nicole A. Volkers, MD, PhD

      Affiliations

    • Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
  • ,
  • Erwin Birnie, PhD

      Affiliations

    • Institute of Health Policy and Management, Erasmus Medical Center, Rotterdam, The Netherlands
  • ,
  • Willem M. Ankum, MD, PhD

      Affiliations

    • Department of Gynecology, Academic Medical Center, Amsterdam, The Netherlands
  • ,
  • Jim A. Reekers, MD, PhD

      Affiliations

    • Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands

Received 8 July 2009; received in revised form 22 October 2009; accepted 19 January 2010. published online 28 June 2010.

Objective

The purpose of this study was to compare clinical outcome and health related quality of life (HRQOL) 5 years after uterine artery embolization (UAE) or hysterectomy in the treatment of menorrhagia caused by uterine fibroids.

Study Design

Patients with symptomatic uterine fibroids who were eligible for hysterectomy were assigned randomly 1:1 to hysterectomy or UAE. Endpoints after 5 years were reintervention rates, menorrhagia, and HRQOL measures that were assessed by validated questionnaires.

Results

Patients were assigned randomly to UAE (n = 88) or hysterectomy (n = 89). Five years after treatment 23 of 81 UAE patients (28.4%) had undergone a hysterectomy because of insufficient improvement of complaints (24.7% after successful UAE). HRQOL measures improved significantly and remained stable until the 5-year follow-up evaluation, with no differences between the groups. UAE had a positive effect both on urinary and defecation function.

Conclusion

UAE is a well-established alternative to hysterectomy about which patients should be counseled.

Key words: fibroid tumor, hysterectomy, menorrhagia, uterine artery embolization

 

 The EMMY trial participants and hospitals are listed with the full-length article at www.AJOG.org.

 Supported by ZonMw “Netherlands Organization for Health Research and Development” (Grant application no: 945-01-017) and by Boston Scientific Corporation, The Netherlands.

 Cite this article as: van der Kooij SM, Hehenkamp WJK, Volkers NA, et al. Uterine artery embolization vs hysterectomy in the treatment of symptomatic uterine fibroids: 5-year outcome from the randomized EMMY trial. Am J Obstet Gynecol 2010;203:105.e1-13.

PII: S0002-9378(10)00079-7

doi:10.1016/j.ajog.2010.01.049

American Journal of Obstetrics & Gynecology
Volume 203, Issue 2 , Pages 105.e1-105.e13, August 2010