Objective: This was a randomized controlled trial to evaluate the safety of uterine artery embolization (UAE) compared with hysterectomy. Study design: Twenty-eight Dutch hospitals recruited 177 patients with symptomatic uterine fibroids and menorrhagia who were eligible for hysterectomy. Patients were randomized to UAE (n = 88) or hysterectomy (n = 89). In this paper we evaluate the peri-and postprocedural complications, length of hospital stay, unscheduled visits, and readmission rates up to 6 weeks’post-intervention. Analysis was by intention to treat. Results: Bilateral UAE failure occurred in 4 patients (4.9%). Major complications occurred in 4.9%(UAE) and 2.7%(hysterectomy) of cases (P = .68). The minor complication rate from discharge until 6 weeks after was significantly higher in the UAE group than in the hysterectomy group (58.0%vs 40.0%; RR 1.45 1.04-2.02 ; P = .024). UAE patients were more often readmitted (11.1%vs 0%; P = .003). Total length of hospital stay was significantly shorter in UAE patients (mean SD : 2.5 2.7 vs 5.1 1.3 , P < .001). Conclusion: UAE is a procedure similar to hysterectomy with a low major complication rate and with a reduced length of hospital stay. Higher readmission rates after UAE stress the need for careful postprocedural follow-up.
Objective: To determine the efficacy of uterine artery ligation by the vaginal route for the management of symptomatic uterine fibroids. A pilot study had suggested that the procedure was effective. Methods: After bilateral uterine artery ligation, ultrasonic measurements of uterine and fibroid volumes were determined at 6 and 12 months in 21 women (age, 31-49 years)-with symptomatic fibroids. The severity of symptoms was assessed preoperatively and postoperatively. Results: Mean uterine and fibroid volumes were significantly reduced at 6 and 12 months. A consistent pattern of decreased duration of menstrual blood flow was recorded. All participants who completed follow-up expressed satisfaction with treatment outcome. Conclusion: The procedure was found to be a safe, inexpensive, and effective therapeutic option for the treatment of symptomatic uterine fibroids.
