Sexuality and Body Image After Uterine Artery Embolization and Hysterectomy in the Treatment of Uterine Fibroids: A Randomized Comparison

Abstract

In this paper the effect of uterine artery embolization (UAE) on sexual functioning and body image is investigated in a randomized comparison to hysterectomy for symptomatic uterine fibroids. The EMbolization versus hysterectoMY (EMMY) trial is a randomized controlled study, conducted at 28 Dutch hospitals. Patients were allocated hysterectomy (n = 89) or UAE (n = 88). Two validated questionnaires (the Sexual Activity Questionnaire [SAQ] and the Body Image Scale [BIS]) were completed by all patients at baseline, 6 weeks, and 6, 12, 18, and 24 months after treatment. Repeated measurements on SAQ scores revealed no differences between the groups. There was a trend toward improved sexual function in both groups at 2 years, although this failed to reach statistical significance except for the dimensions discomfort and habit in the UAE arm. Overall quality of sexual life deteriorated in a minority of cases at all time points, with no significant differences between the groups (at 24 months: UAE, 29.3%, versus hysterectomy, 23.5%; p = 0.32). At 24 months the BIS score had improved in both groups compared to baseline, but the change was only significant in the UAE group (p = 0.009). In conclusion, at 24 months no differences in sexuality and body image were observed between the UAE and the hysterectomy group. On average, both after UAE and hysterectomy sexual functioning and body image scores improved, but significantly so only after UAE.

Uterine artery embolization versus surgery for symptomatic uterine fibroids: a randomized controlled trial and a meta-analysis of the literature

“…With our search criterion, 107 individual records were found, but 13 publications [5][6][7][8][9][16][17][18][19][20][21][22][23] were Wnally included. Hehenkamp WJ et al study and other seven articles reported diVerent kinds of data in the same RCT, the randomized EMMY trial [6,[16][17][18][19][21][22][23].…”

Complications of Fibroid Embolisation

“…In contrast to this case report, a study of 141 premenopausal women who underwent UAE for symptomatic fibroids observed significant improvements in sexual function and well being while problems associated with orgasm and pain reduced (Voogt et al 2008). Similar improvements in sexual activity and satisfaction following UAE have been described in other studies (Hehenkamp et al 2007;Smith et al 2004).…”

Impact of gynecological surgery on female sexual function

“…In both the groups sexual functioning and body image improved; however, significant increases were seen more often in the uterine artery embolization group. 51 Others conducted a large study comparing hysterectomy with endometrial ablation for dysfunctional uterine bleeding. This was a prospective cohort of over 11 000 women, of whom 8900 completed questions related to psychosexual function 5 years after treatment.…”