Outcome of uterine embolization and hysterectomy for leiomyomas: Results of a multicenter study

Spies, James B.; Cooper, Jay M.; Worthington-Kirsch, Robert L.; Lipman, John C.; Mills, Benjie B.; Benenati, James F.

doi:10.1016/j.ajog.2004.03.037

Cited by 124 publications

(24 citation statements)

References 17 publications

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“…In the literature, there is one additional study using Pictorial Bleeding Assessment Chart reduction in 76 patients treated by embolization and reported improvement in 55.6% after 3 months and 58.1% after 6 months, which is significantly less than in this study (8) .…”

Section: Discussioncontrasting

confidence: 72%

“…This proportion is in accordance with other reporting outcomes after uterine ' leiomyoma embolization or laparoscopic occlusion. In two larger studies, subsequent interventions or readmission occurred in 10.5% after 21 months (6) and in 7.5% after 17 months, (8) respectively. In both of these studies, the main In order to perform a successful laparoscopic uterine artery occlusion; the surgeons has to be equipped with the necessary laparoscopic skills and should be able to precisely locate the uterine artery in order to correctly ligate the vessels.…”

Section: Discussionmentioning

confidence: 95%

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Comparison Between Laparoscopic and Radiologic Uterine Arteries Occlusion in the Treatment of Symptomatic Uterine Myomas

Eltotongy

El-Negeri

Shokeir

et al. 2009

The Egypt. J. of Fert.y of Steri.

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Objective: To prospectively compare the effectiveness and safety of the two modalities of uterine arteries occlusion (laparoscopy versus embolization.); as a treatment of symptomatizing uterine fibroids; together with clinical outcome after 6 and 12 months follow up. Methods: Seventy-six consecutive premenopausal women with symptomatic uterine leiomyomata; non of them desired any further pregnancy. They were randomized to treatment either with laparoscopic occlusion or by radiologic embolization of uterine arteries. The primary outcome was reduction of blood loss from prelreatment to 6 and 12 months postoperatively, as measured by the patients own assessment (subjective). Secondary outcomes included, postoperative pain, complications, secondary interventions, and failures. Results: Seventy women were included in two groups; 36 and 12-month follow-up data were available for all the patients in each group. The percentage reduction in bleeding assessment did not differe between the treatment groups (88.90% after laparoscopic uterine arteries occlusion versus 88.51% after embolization. P-0.48). Fewer participants in the two groups complained of heavy bleeding after 12 months (8.57% compared with 5.7% with embolization, ¥=.044). Conclusion: Both laparoscopic occlusion and superselective embolization of uterine arteries improved clinical symptoms in the majority of patients. Participants with the radiologic embolization pocedure had more postoperative pain but less heavier menstrual bleeding 12 months afte treatment.Uterine leiomyomata, which occur in one of every four to five women during reproductive life; is the most common solid pelvic tumour in women "\ Menstrual abnormalities-especially menorrhagia, which often leads to iron deficiency anaemia -are the most common complications of uterine leiomyomata ^ \

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Section: Discussioncontrasting

confidence: 72%

Section: Discussionmentioning

confidence: 95%

Comparison Between Laparoscopic and Radiologic Uterine Arteries Occlusion in the Treatment of Symptomatic Uterine Myomas

Eltotongy

El-Negeri

Shokeir

et al. 2009

The Egypt. J. of Fert.y of Steri.

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“…In addition, two observational multicentre studies comparing UAE and hysterectomy are reported, one prospective [10] and one retrospective [20]. In the multicentre trials published, most individual centres have included only a small number of patients resulting in a Data are numbers of patients and data in parentheses are percentages a These data are not available from four patients because they were not treated b Data are mean ± standard deviations, with ranges in parentheses unless otherwise indicated A strength of our trial is that the research population was unselected; patients were not excluded according to the size or location of leiomyomas or presenting symptoms, i.e.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, in the EMMY trial there were no differences in improvement of bulk-related symptoms between groups; however, women with isolated pressure symptoms were excluded [7]. In a multicentre prospective observational study patients who had undergone hysterectomy experienced better improvement of pelvic pressure [10].…”

Section: Primary Endpointmentioning

confidence: 99%

“…Thus far, only three randomised, controlled trials have been reported [4][5][6][7][8][9], only one of which included both menorrhagia and pressure symptoms in the inclusion criteria [5]. In addition, some multicentre case series have been published that compare UAE with hysterectomy [10,11] and evaluate UAE alone [12][13][14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

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