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Published in: CardioVascular and Interventional Radiology 2/2006

01-04-2006 | CLINICAL INVESTIGATIONS

Pain and Return to Daily Activities after Uterine Artery Embolization and Hysterectomy in the Treatment of Symptomatic Uterine Fibroids: Results from the Randomized EMMY Trial

Authors: Wouter J.K. Hehenkamp, Nicole A. Volkers, Erwin Birnie, Jim A. Reekers, Willem M. Ankum

Published in: CardioVascular and Interventional Radiology | Issue 2/2006

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Abstract

Purpose

To evaluate the safety and efficacy of uterine artery embolization (UAE) and hysterectomy for symptomatic uterine fibroids by means of a randomized controlled trial. The present paper analyses short-term outcomes, i.e., pain and return to daily activities.

Methods

Patients were randomized (1:1) to UAE or hysterectomy. Pain was assessed during admission and after discharge, both quantitatively and qualitatively, using a numerical rating scale and questionnaires. Time to return to daily activities was assessed by questionnaire.

Results

Seventy-five patients underwent hysterectomy and 81 patients underwent UAE. UAE patients experienced significantly less pain during the first 24 hr after treatment (p = 0.012). Non-white patients had significantly higher pain scores. UAE patients returned significantly sooner to daily activities than hysterectomy patients (for paid work: 28.1 versus 63.4 days; p < 0.001). In conclusion, pain appears to be less after UAE during hospital stay. Return to several daily activities was in favor of UAE in comparison with hysterectomy.
Literature
1.
go back to reference Ravina JH, Herbreteau D, Ciraru-Vigneron N, et al (1995) Arterial embolisation to treat uterine myomata. Lancet 346:671–672CrossRefPubMed Ravina JH, Herbreteau D, Ciraru-Vigneron N, et al (1995) Arterial embolisation to treat uterine myomata. Lancet 346:671–672CrossRefPubMed
2.
go back to reference Pron G, Bennett J, Common A, et al (2003) The Ontario Uterine Fibroid Embolization Trial. 2. Uterine fibroid reduction and symptom relief after uterine artery embolization for fibroids. Fertil Steril 79:120–127PubMed Pron G, Bennett J, Common A, et al (2003) The Ontario Uterine Fibroid Embolization Trial. 2. Uterine fibroid reduction and symptom relief after uterine artery embolization for fibroids. Fertil Steril 79:120–127PubMed
3.
go back to reference McLucas B, Adler L, Perrella R (2001) Uterine fibroid embolization: Nonsurgical treatment for symptomatic fibroids. J Am Coll Surg 192:95–105CrossRefPubMed McLucas B, Adler L, Perrella R (2001) Uterine fibroid embolization: Nonsurgical treatment for symptomatic fibroids. J Am Coll Surg 192:95–105CrossRefPubMed
4.
go back to reference Walker WJ, Pelage JP (2002) Uterine artery embolisation for symptomatic fibroids: Clinical results in 400 women with imaging follow up. Br J Obstet Gynaecol 109:1262–1272 Walker WJ, Pelage JP (2002) Uterine artery embolisation for symptomatic fibroids: Clinical results in 400 women with imaging follow up. Br J Obstet Gynaecol 109:1262–1272
5.
go back to reference Spies JB, Ascher SA, Roth AR, et al (2001) Uterine artery embolization for leiomyomata. Obstet Gynecol 98:29–34CrossRefPubMed Spies JB, Ascher SA, Roth AR, et al (2001) Uterine artery embolization for leiomyomata. Obstet Gynecol 98:29–34CrossRefPubMed
6.
go back to reference Pelage JP, Soyer P, Le Dref O, et al (1999) Uterine arteries: Bilateral catheterization with a single femoral approach and a single 5-F catheter—technical note. Radiology 210:573–575PubMed Pelage JP, Soyer P, Le Dref O, et al (1999) Uterine arteries: Bilateral catheterization with a single femoral approach and a single 5-F catheter—technical note. Radiology 210:573–575PubMed
7.
go back to reference Worthington-Kirsch RL (2005) Uterine artery embolization for fibroid disease is not experimental. Cardiovasc Intervent Radiol 28:148–149CrossRefPubMed Worthington-Kirsch RL (2005) Uterine artery embolization for fibroid disease is not experimental. Cardiovasc Intervent Radiol 28:148–149CrossRefPubMed
8.
go back to reference Moss JG (2005) Uterine fibroid embolization: More evidence is required. Cardiovasc Intervent Radiol 28:150–152PubMed Moss JG (2005) Uterine fibroid embolization: More evidence is required. Cardiovasc Intervent Radiol 28:150–152PubMed
9.
go back to reference Reekers JA, (2004) Uterine artery embolization: What the others say... Cardiovasc Intervent Radiol 27:305–306CrossRefPubMed Reekers JA, (2004) Uterine artery embolization: What the others say... Cardiovasc Intervent Radiol 27:305–306CrossRefPubMed
10.
go back to reference Hehenkamp WJK, Volkers NA, Donderwinkel PFJ, de Blok S, Birnie E, Ankum WM, et al. (in press) Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids (EMMY trial): Peri- and post-procedural results from a randomized controlled trial. Am J Obstet Gynecol Hehenkamp WJK, Volkers NA, Donderwinkel PFJ, de Blok S, Birnie E, Ankum WM, et al. (in press) Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids (EMMY trial): Peri- and post-procedural results from a randomized controlled trial. Am J Obstet Gynecol
11.
go back to reference Pinto I, Chimeno P, Romo A, et al (2003) Uterine fibroids: Uterine artery embolization versus abdominal hysterectomy for treatment. A prospective, randomized, and controlled clinical trial. Radiology 226:425–431PubMed Pinto I, Chimeno P, Romo A, et al (2003) Uterine fibroids: Uterine artery embolization versus abdominal hysterectomy for treatment. A prospective, randomized, and controlled clinical trial. Radiology 226:425–431PubMed
12.
go back to reference Huskisson EC (1974) Measurement of pain. Lancet II:1127–1131 Huskisson EC (1974) Measurement of pain. Lancet II:1127–1131
13.
go back to reference Zupi E, Pocek M, Dauri M, et al (2003) Selective uterine artery embolization in the management of uterine myomas. Fertil Steril 79:107–111CrossRefPubMed Zupi E, Pocek M, Dauri M, et al (2003) Selective uterine artery embolization in the management of uterine myomas. Fertil Steril 79:107–111CrossRefPubMed
14.
go back to reference Bruno J, Sterbis K, Flick P, et al (2004) Recovery after uterine artery embolization for leiomyomas: A detailed analysis of its duration and severity. J Vasc Interv Radiol 15:801–807PubMed Bruno J, Sterbis K, Flick P, et al (2004) Recovery after uterine artery embolization for leiomyomas: A detailed analysis of its duration and severity. J Vasc Interv Radiol 15:801–807PubMed
15.
go back to reference Brunereau L, Herbreteau D, Gallas S, et al (2000) Uterine artery embolization in the primary treatment of uterine leiomyomas: Technical features and prospective follow-up with clinical and sonographic examinations in 58 patients. AJR Am J Roentgenol 175:1267–1272PubMed Brunereau L, Herbreteau D, Gallas S, et al (2000) Uterine artery embolization in the primary treatment of uterine leiomyomas: Technical features and prospective follow-up with clinical and sonographic examinations in 58 patients. AJR Am J Roentgenol 175:1267–1272PubMed
16.
17.
go back to reference Klein A, Schwartz ML (2001) Uterine artery embolization for the treatment of uterine fibroids: An outpatient procedure. Am J Obstet Gynecol 184:1556–1560CrossRefPubMed Klein A, Schwartz ML (2001) Uterine artery embolization for the treatment of uterine fibroids: An outpatient procedure. Am J Obstet Gynecol 184:1556–1560CrossRefPubMed
18.
go back to reference Siskin GP, Stainken BF, Dowling K, et al (2000) Outpatient uterine artery embolization for symptomatic uterine fibroids: Experience in 49 patients. J Vasc Interv Radiol 11:305–311PubMed Siskin GP, Stainken BF, Dowling K, et al (2000) Outpatient uterine artery embolization for symptomatic uterine fibroids: Experience in 49 patients. J Vasc Interv Radiol 11:305–311PubMed
19.
go back to reference Pron G, Mocarski E, Bennett J, et al (2003) Tolerance, hospital stay, and recovery after uterine artery embolization for fibroids: The Ontario Uterine Fibroid Embolization Trial. J Vasc Interv Radiol 14:1243–1250PubMed Pron G, Mocarski E, Bennett J, et al (2003) Tolerance, hospital stay, and recovery after uterine artery embolization for fibroids: The Ontario Uterine Fibroid Embolization Trial. J Vasc Interv Radiol 14:1243–1250PubMed
20.
go back to reference Razavi MK, Hwang G, Jahed A, et al (2003) Abdominal myomectomy versus uterine fibroid embolization in the treatment of symptomatic uterine leiomyomas. AJR Am J Roentgenol 180:1571–1575PubMed Razavi MK, Hwang G, Jahed A, et al (2003) Abdominal myomectomy versus uterine fibroid embolization in the treatment of symptomatic uterine leiomyomas. AJR Am J Roentgenol 180:1571–1575PubMed
21.
go back to reference Garry R, Fountain J, Brown J, et al (2004) EVALUATE hysterectomy trial: A multicentre randomised trial comparing abdominal, vaginal and laparoscopic methods of hysterectomy. Health Technol Assess 8:1–154PubMed Garry R, Fountain J, Brown J, et al (2004) EVALUATE hysterectomy trial: A multicentre randomised trial comparing abdominal, vaginal and laparoscopic methods of hysterectomy. Health Technol Assess 8:1–154PubMed
Metadata
Title
Pain and Return to Daily Activities after Uterine Artery Embolization and Hysterectomy in the Treatment of Symptomatic Uterine Fibroids: Results from the Randomized EMMY Trial
Authors
Wouter J.K. Hehenkamp
Nicole A. Volkers
Erwin Birnie
Jim A. Reekers
Willem M. Ankum
Publication date
01-04-2006
Publisher
Springer-Verlag
Published in
CardioVascular and Interventional Radiology / Issue 2/2006
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-005-0195-9

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