Uterine artery embolization may be an alternative to hysterectomy

According to the findings of the 5-year, randomized, controlled, multicenter embolization versus hysterectomy (EMMY) trial, uterine artery embolization (UAE) may be an alternative to hysterectomy for some women with symptomatic uterine fibroids.

Women with symptomatic uterine fibroids who received either UAE (n=88) or hysterectomy (n=89) were followed for 5 years. Endpoints were reintervention, menorrhagia, menopause and related symptoms, quality of life, urinary and defecation functions, and satisfaction with treatment. Study measures were conducted by questionnaires at baseline and at fixed intervals thereafer.

Although 28.4% of the women who received UAE subsequently underwent hysterectomy because of insufficient improvement of menorrhagia, quality-of-life measures improved significantly and remained stable throughout the 5-year follow-up period, with no significant differences between the groups.

After 5 years, 82.7% of women in the UAE group were either symptom-free or reported good or moderate improvement in symptoms. Of those women who still had their uterus, 75.9% were symptom-free or reported good or moderate improvement in symptoms.

Because 82.6% of the secondary hysterectomies occurred within 2 years of UAE, not undergoing a hysterectomy in the first 2 years afterward may be a predictor of UAE success.

Van der Kooij SM, Hehenkamp WJK, Volkers NA, Birnie E, Ankum WM, Reekers JA. 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(2):105.e1-e13.