Uterine artery embolization for symptomatic fibroids: Long-term changes in disease-specific symptoms and quality of life

Abstract

Background: To investigate the long-term changes in health-related quality of life (HRQOL) after uterine artery embolization (UAE) for symptomatic fibroids, we conducted a prospective cohort study. Methods: Eighty-two women completed the validated uterine fibroid symptom and QOL (UFS-QOL) questionnaire before UAE. Short-term Results after a median of 8 months (range: 320) have been published previously. Patients were asked to complete the questionnaire again after a median of 6.3 years (range: 57.6). Secondary outcome measures were the frequency of additional surgical or endovascular procedures due to treatment failure and the menstrual status. Results: A total of 4/82 patients (5) were lost to follow-up. Of the remaining 78 patients, 11 underwent surgery or repeat UAE (hysterectomy n 6, myomectomy n 1, UAE n 4) at a median of 13 months (range: 570) after UAE. Two patients failed clinically but did not undergo a second intervention. The overall treatment failure rate 6 years after UAE was 17. Clinical long-term follow-up regarding symptom control and quality of life was available in the remaining 65 patients. Symptom severity scores decreased from a median of 37.50 (quartile range, QR: 28.13-53.13) to 0.00 (QR: 0.00-10.94) (P < 0.001), whereas the HRQOL total score increased from a median of 64.66 (QR: 46.34-79.10) to 100.00 (QR: 96.12-100.00) (P< 0.001). Both scores also improved significantly compared with short-term Results (P=0.006 and P=0.041). Permanent amenorrhea was observed in five patients at a median of 18 months (range: 1046) after UAE and at a mean patient age of 50 years. Conclusions: UAE leads to durable relief of fibroid-related symptoms and sustained improvement in HRQOL. After 6 years, clinical failure can be expected in 17, and most of these patients require secondary invasive treatment. © The Author 2011. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissionsoup.com2011 © © The Author 2011. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissionsoup.com.