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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

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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.

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Acknowledgments

We thank all participating patients, EMMY trial group members, nurses, and other contributors who made this trial possible.

The EMMY trial participants and hospitals:

J. Reekers, W. Ankum, M. Burger, G. Bonsel, E. Birnie, W. Hehenkamp, N. Volkers (Academic Medical Centre, Amsterdam); S. de Blok, C. de Vries (Onze Lieve Vrouwe Gasthuis, Amsterdam); T. Salemans, G. Veldhuyzen van Zanten (Atrium Medical Centre, Heerlen); D. Tinga, T. Prins (Groningen University Hospital, Groningen); P. Sleyffers, M. Rutten (Bosch Medical Centre, Den Bosch); M. Smeets, N. Aarts (Bronovo Hospital, The Hague); P. van der Moer, D. Vroegindeweij (Medical Centre Rijnmond-Zuid, Rotterdam); F. Boekkooi, L. Lampmann (St. Elisabeth Hospital, Tilburg); G. Kleiverda, (Flevo Hospital, Almere); R. Dik, J. Marsman (Gooi-Noord Hospital, Laren); C. de Nooijer, I. Hendriks, G. Guit (Kennemer Gasthuis, Haarlem); H. Ottervanger, H. van Overhagen, (Leyenburg Hospital, The Hague); A. Thurkow (St. Lucas/Andreas Hospital, Amsterdam); P. Donderwinkel, C. Holt (Martini Hospital, Groningen); A. Adriaanse, J. Wallis (Medical Centre Alkmaar, Alkmaar); J. Hirdes, J. Schutte, W. de Rhoter (Medical Centre Leeuwarden, Leeuwarden); P. Paaymans, R. Schepers-Bok (Hospital Midden-Twente, Hengelo); G. van Doorn, J. Krabbe, A. Huisman, (Medisch Spectrum Twente, Enschede); M. Hermans, R. Dallinga, (Reinier de Graaf Gasthuis, Delft); F. Reijnders, J. Spithoven, (Slingeland Hospital, Doetichem); W. Jager, P. Veekmans, (St. Jans Gasthuis, Weert); P. van der Heijden, M. Veereschild, J. van den Hout, (Twenteborg Hospital, Almelo); I. van Seumeren, A. Heinz, R. Lo, W. Mali, (University Hospital Utrecht, Utrecht); J. Lind, Th. de Rooy (Westeinde Hospital, The Hague); M. Bulstra, F. Sanders (Diakonessenhuis Utrecht, Utrecht); J. Doornbos (De Heel Hospital, Zaandam); P. Dijkhuizen, M. van Kints (Rijnstate Hospital, Arnhem); Ph. Engelen, R. Heijboer (Slotervaart Hospital, Amsterdam).

Funding: The EMMY trial is funded by ZonMw “Netherlands Organization for Health Research and Development” (Grant application number: 945-01-017) and supported by Boston Scientific Corporation, The Netherlands.

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Authors and Affiliations

  1. Department of Gynaecology, Academic Medical Centre, Meibergdreef 9, Amsterdam, AZ, 1105, The Netherlands

    Wouter J.K. Hehenkamp & Willem M. Ankum

  2. Department of Radiology, Academic Medical Centre, Meibergdreef 9, Amsterdam, AZ, 1105, The Netherlands

    Nicole A. Volkers & Jim A. Reekers

  3. Department of Public Health Epidemiology, Academic Medical Centre, Meibergdreef 9, Amsterdam, AZ, 1105, The Netherlands

    Erwin Birnie

Authors
  1. Wouter J.K. Hehenkamp
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  2. Nicole A. Volkers
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  3. Erwin Birnie
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  4. Jim A. Reekers
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  5. Willem M. Ankum
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Corresponding author

Correspondence to Wouter J.K. Hehenkamp.

Additional information

Wouter J.K. Hehenkamp and Nicole A. Volkers are contributed equally to this manuscript.

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Hehenkamp, W.J., Volkers, N.A., Birnie, E. et al. 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. Cardiovasc Intervent Radiol 29, 179–187 (2006). https://doi.org/10.1007/s00270-005-0195-9

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  • DOI: https://doi.org/10.1007/s00270-005-0195-9

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