A Prospective Multicenter Comparative Study between Myomectomy and Uterine Artery Embolization with Polyvinyl Alcohol Microspheres: Long-term Clinical Outcomes in Patients with Symptomatic Uterine Fibroids

Uterine Artery Embolization versus Myomectomy: Impact on Quality of Life—Results of the FUME (Fibroids of the Uterus: Myomectomy versus Embolization) Trial

“…A number of comparative studies between UAE and other procedures have been published, including two large prospective cohort studies comparing UAE to myomectomy [12] and hysterectomy [13], and all show similar positive results. Level 1 evidence is now available from two randomized trials [14,15].…”

Complications of Fibroid Embolisation

“…(Spies et al 2002). Several randomised controlled trials have described major complications in up to 15 % of patients following UAE (Pinto et al 2003;Mara et al 2006;Volkers et al 2006;Manyonda et al 2011;Dutton et al 2007;Edwards et al 2007) and smaller observational studies have also reported higher complication rates of 11-26 % (Razavi et al 2003;Goodwin et al 2006;Siskin et al 2006). On the other hand, the most recently published prospective randomised trial (FUME) reported a much lower major complication rate of 2.9 % (Manyonda et al 2011).…”

“…Such complications are rare in UAE as the patients are young with no underlying arterial disease and procedural anticoagulation with heparin is not required. Groin haematoma has been reported in 0.25-20 % of patients (Pinto et al 2003;Spies et al 2002;Manyonda et al 2011;Goodwin et al 2006;Siskin et al 2006;Dutton et al 2007), arterial injury has been seen in up to 0.5-10 % (Pinto et al 2003;Spies et al 2002;Pelage et al 2000), femoral nerve injury in up to 1.6 % (Razavi et al 2003;Spies et al 2002) and adverse reaction to contrast medium in up to 2.5 % (Spies et al 2002;Manyonda et al 2011;Dutton et al 2007). The majority of these complications are minor requiring either no secondary intervention or overnight stay for observation.…”

Symptoms Improvement after Uterine Artery Embolization for Myomas Management

“…Indeed, studies comparing clinical results of myomectomy (open surgery or laparoscopy) and UAE revealed similar clinical success rates [16][17][18][19], with advantages for UAE concerning shorter hospital stay and recovery time [20], since adequate indication and successful performance bases on four important aspects: strict definition of the clinical entities involved in the disease and its treatment, careful selection of patients, technique of embolization, and post-surgical management.…”