UAE or hysterectomy: the ongoing debate

February 21, 2008

While uterine artery embolization (UAE) results in fewer complications than hysterectomy (19% vs. 26%, respectively, P=0.001), fewer women undergoing UAE report relief from fibroid symptoms (85% vs. 95%, P<0.0001), fewer report feeling better (84% vs. 96%, P<0.0001), and the women receiving UAE are more likely to require further treatment for fibroid symptoms. That's the conclusion of a British multi-center retrospective study comparing hysterectomy and UAE for the treatment of symptomatic uterine fibroids. Additional results: 3.9% of women required a hysterectomy in the first year after UAE and an additional 7.4% required a hysterectomy during years 2 through 7 after UAE.

While uterine artery embolization (UAE) results in fewer complications than hysterectomy (19% vs. 26%, respectively, P=0.001), fewer women undergoing UAE report relief from fibroid symptoms (85% vs. 95%, P<0.0001), fewer report feeling better (84% vs. 96%, P<0.0001), and the women receiving UAE are more likely to require further treatment for fibroid symptoms. That's the conclusion of a British multi-center retrospective study comparing hysterectomy and UAE for the treatment of symptomatic uterine fibroids. Additional results: 3.9% of women required a hysterectomy in the first year after UAE and an additional 7.4% required a hysterectomy during years 2 through 7 after UAE.

Despite these numbers, 91% of the women in the UAE group would recommend the procedure to a friend versus 85% of the women undergoing hysterectomy.

The study included 459 women receiving hysterectomy and 649 women receiving UAE, and concluded that both procedures are safe and effective, making the choice largely a matter of personal preference.

Dutton S, Hirst A, McPherson K, et al. A UK multicentre retrospective cohort study comparing hysterectomy and uterine artery embolisation for the treatment of symptomatic uterine fibroids (HOPEFUL study): main results on medium-term safety and efficacy. BJOG. 2007;114:1340-1351.