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Uterine artery embolisation versus hysterectomy for leiomyomas: primary and 2-year follow-up results of a randomised prospective clinical trial

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Abstract

Objective

To compare uterine artery embolisation (UAE) and hysterectomy for the treatment of leiomyomas at 2-year follow-up in a prospective, randomised, single-centre study.

Methods

Fifty-seven symptomatic patients were randomised to UAE (n = 27) or hysterectomy (n = 30). Complications, recovery, reinterventions and satisfaction with treatment were recorded. Primary endpoint was improvement of symptoms. Analyses were performed by intent-to-treat and per protocol.

Results

Two hysterectomy patients (7%) developed major complications. Hospital discharge occurred earlier after UAE than after hysterectomy (p < 0.001). Length of sick leave was longer after hysterectomy than after UAE (p < 0.001). Twenty-two (82%) UAE patients and 28 (93%) hysterectomy patients reported overall relief of symptoms (p = 0.173). In 12/18 (67%) UAE patients menorrhagia was completely resolved or reduced. Improvement of pressure symptoms was reported significantly more by UAE patients than by hysterectomy patients (19/20 [95%] versus 18/26 [69%], respectively; p = 0.029). Five (19%) UAE patients underwent additional interventions due to worsening symptoms. Twenty-four (89%) UAE patients and 29 (97%) hysterectomy patients would have chosen treatment again (p = 0.336).

Conclusion

UAE gave relief of symptoms (apart from menorrhagia) comparable to hysterectomy with less severe complications, but with an increased rate of secondary interventions. UAE may be the preferable treatment especially for patients with pressure symptoms.

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Acknowledgements

This work was supported by financial contributors from the Finnish Cultural Foundation, Radiological Society of Finland, Society of Interventional Radiology of Finland, Instrumentarium Science Foundation, The Finnish Medical Society Duodecim, and Kuopio University Hospital grant #5063518.

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Authors and Affiliations

  1. Department of Clinical Radiology, Kuopio University Hospital, P.O. Box 1777, 70211, Kuopio, Finland

    Anu Ruuskanen, Petri Sipola & Hannu Manninen

  2. Department of Obstetrics and Gynaecology, Kuopio University Hospital, P.O. Box 1777, 70211, Kuopio, Finland

    Maritta Hippeläinen

  3. University of Eastern Finland, Faculty of Health Sciences, Institute of Clinical Medicine, P.O. Box 1627, 70211, Kuopio, Finland

    Petri Sipola & Hannu Manninen

Authors
  1. Anu Ruuskanen
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  2. Maritta Hippeläinen
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  4. Hannu Manninen
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Correspondence to Anu Ruuskanen.

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Ruuskanen, A., Hippeläinen, M., Sipola, P. et al. Uterine artery embolisation versus hysterectomy for leiomyomas: primary and 2-year follow-up results of a randomised prospective clinical trial. Eur Radiol 20, 2524–2532 (2010). https://doi.org/10.1007/s00330-010-1829-0

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  • DOI: https://doi.org/10.1007/s00330-010-1829-0

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