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Erschienen in: CardioVascular and Interventional Radiology 2/2006

01.04.2006 | CLINICAL INVESTIGATIONS

Pain and Return to Daily Activities after Uterine Artery Embolization and Hysterectomy in the Treatment of Symptomatic Uterine Fibroids: Results from the Randomized EMMY Trial

verfasst von: Wouter J.K. Hehenkamp, Nicole A. Volkers, Erwin Birnie, Jim A. Reekers, Willem M. Ankum

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 2/2006

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Abstract

Purpose

To evaluate the safety and efficacy of uterine artery embolization (UAE) and hysterectomy for symptomatic uterine fibroids by means of a randomized controlled trial. The present paper analyses short-term outcomes, i.e., pain and return to daily activities.

Methods

Patients were randomized (1:1) to UAE or hysterectomy. Pain was assessed during admission and after discharge, both quantitatively and qualitatively, using a numerical rating scale and questionnaires. Time to return to daily activities was assessed by questionnaire.

Results

Seventy-five patients underwent hysterectomy and 81 patients underwent UAE. UAE patients experienced significantly less pain during the first 24 hr after treatment (p = 0.012). Non-white patients had significantly higher pain scores. UAE patients returned significantly sooner to daily activities than hysterectomy patients (for paid work: 28.1 versus 63.4 days; p < 0.001). In conclusion, pain appears to be less after UAE during hospital stay. Return to several daily activities was in favor of UAE in comparison with hysterectomy.
Literatur
1.
Zurück zum Zitat Ravina JH, Herbreteau D, Ciraru-Vigneron N, et al (1995) Arterial embolisation to treat uterine myomata. Lancet 346:671–672CrossRefPubMed Ravina JH, Herbreteau D, Ciraru-Vigneron N, et al (1995) Arterial embolisation to treat uterine myomata. Lancet 346:671–672CrossRefPubMed
2.
Zurück zum Zitat Pron G, Bennett J, Common A, et al (2003) The Ontario Uterine Fibroid Embolization Trial. 2. Uterine fibroid reduction and symptom relief after uterine artery embolization for fibroids. Fertil Steril 79:120–127PubMed Pron G, Bennett J, Common A, et al (2003) The Ontario Uterine Fibroid Embolization Trial. 2. Uterine fibroid reduction and symptom relief after uterine artery embolization for fibroids. Fertil Steril 79:120–127PubMed
3.
Zurück zum Zitat McLucas B, Adler L, Perrella R (2001) Uterine fibroid embolization: Nonsurgical treatment for symptomatic fibroids. J Am Coll Surg 192:95–105CrossRefPubMed McLucas B, Adler L, Perrella R (2001) Uterine fibroid embolization: Nonsurgical treatment for symptomatic fibroids. J Am Coll Surg 192:95–105CrossRefPubMed
4.
Zurück zum Zitat Walker WJ, Pelage JP (2002) Uterine artery embolisation for symptomatic fibroids: Clinical results in 400 women with imaging follow up. Br J Obstet Gynaecol 109:1262–1272 Walker WJ, Pelage JP (2002) Uterine artery embolisation for symptomatic fibroids: Clinical results in 400 women with imaging follow up. Br J Obstet Gynaecol 109:1262–1272
5.
Zurück zum Zitat Spies JB, Ascher SA, Roth AR, et al (2001) Uterine artery embolization for leiomyomata. Obstet Gynecol 98:29–34CrossRefPubMed Spies JB, Ascher SA, Roth AR, et al (2001) Uterine artery embolization for leiomyomata. Obstet Gynecol 98:29–34CrossRefPubMed
6.
Zurück zum Zitat Pelage JP, Soyer P, Le Dref O, et al (1999) Uterine arteries: Bilateral catheterization with a single femoral approach and a single 5-F catheter—technical note. Radiology 210:573–575PubMed Pelage JP, Soyer P, Le Dref O, et al (1999) Uterine arteries: Bilateral catheterization with a single femoral approach and a single 5-F catheter—technical note. Radiology 210:573–575PubMed
7.
Zurück zum Zitat Worthington-Kirsch RL (2005) Uterine artery embolization for fibroid disease is not experimental. Cardiovasc Intervent Radiol 28:148–149CrossRefPubMed Worthington-Kirsch RL (2005) Uterine artery embolization for fibroid disease is not experimental. Cardiovasc Intervent Radiol 28:148–149CrossRefPubMed
8.
Zurück zum Zitat Moss JG (2005) Uterine fibroid embolization: More evidence is required. Cardiovasc Intervent Radiol 28:150–152PubMed Moss JG (2005) Uterine fibroid embolization: More evidence is required. Cardiovasc Intervent Radiol 28:150–152PubMed
9.
Zurück zum Zitat Reekers JA, (2004) Uterine artery embolization: What the others say... Cardiovasc Intervent Radiol 27:305–306CrossRefPubMed Reekers JA, (2004) Uterine artery embolization: What the others say... Cardiovasc Intervent Radiol 27:305–306CrossRefPubMed
10.
Zurück zum Zitat Hehenkamp WJK, Volkers NA, Donderwinkel PFJ, de Blok S, Birnie E, Ankum WM, et al. (in press) Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids (EMMY trial): Peri- and post-procedural results from a randomized controlled trial. Am J Obstet Gynecol Hehenkamp WJK, Volkers NA, Donderwinkel PFJ, de Blok S, Birnie E, Ankum WM, et al. (in press) Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids (EMMY trial): Peri- and post-procedural results from a randomized controlled trial. Am J Obstet Gynecol
11.
Zurück zum Zitat Pinto I, Chimeno P, Romo A, et al (2003) Uterine fibroids: Uterine artery embolization versus abdominal hysterectomy for treatment. A prospective, randomized, and controlled clinical trial. Radiology 226:425–431PubMed Pinto I, Chimeno P, Romo A, et al (2003) Uterine fibroids: Uterine artery embolization versus abdominal hysterectomy for treatment. A prospective, randomized, and controlled clinical trial. Radiology 226:425–431PubMed
12.
Zurück zum Zitat Huskisson EC (1974) Measurement of pain. Lancet II:1127–1131 Huskisson EC (1974) Measurement of pain. Lancet II:1127–1131
13.
Zurück zum Zitat Zupi E, Pocek M, Dauri M, et al (2003) Selective uterine artery embolization in the management of uterine myomas. Fertil Steril 79:107–111CrossRefPubMed Zupi E, Pocek M, Dauri M, et al (2003) Selective uterine artery embolization in the management of uterine myomas. Fertil Steril 79:107–111CrossRefPubMed
14.
Zurück zum Zitat Bruno J, Sterbis K, Flick P, et al (2004) Recovery after uterine artery embolization for leiomyomas: A detailed analysis of its duration and severity. J Vasc Interv Radiol 15:801–807PubMed Bruno J, Sterbis K, Flick P, et al (2004) Recovery after uterine artery embolization for leiomyomas: A detailed analysis of its duration and severity. J Vasc Interv Radiol 15:801–807PubMed
15.
Zurück zum Zitat Brunereau L, Herbreteau D, Gallas S, et al (2000) Uterine artery embolization in the primary treatment of uterine leiomyomas: Technical features and prospective follow-up with clinical and sonographic examinations in 58 patients. AJR Am J Roentgenol 175:1267–1272PubMed Brunereau L, Herbreteau D, Gallas S, et al (2000) Uterine artery embolization in the primary treatment of uterine leiomyomas: Technical features and prospective follow-up with clinical and sonographic examinations in 58 patients. AJR Am J Roentgenol 175:1267–1272PubMed
16.
17.
Zurück zum Zitat Klein A, Schwartz ML (2001) Uterine artery embolization for the treatment of uterine fibroids: An outpatient procedure. Am J Obstet Gynecol 184:1556–1560CrossRefPubMed Klein A, Schwartz ML (2001) Uterine artery embolization for the treatment of uterine fibroids: An outpatient procedure. Am J Obstet Gynecol 184:1556–1560CrossRefPubMed
18.
Zurück zum Zitat Siskin GP, Stainken BF, Dowling K, et al (2000) Outpatient uterine artery embolization for symptomatic uterine fibroids: Experience in 49 patients. J Vasc Interv Radiol 11:305–311PubMed Siskin GP, Stainken BF, Dowling K, et al (2000) Outpatient uterine artery embolization for symptomatic uterine fibroids: Experience in 49 patients. J Vasc Interv Radiol 11:305–311PubMed
19.
Zurück zum Zitat Pron G, Mocarski E, Bennett J, et al (2003) Tolerance, hospital stay, and recovery after uterine artery embolization for fibroids: The Ontario Uterine Fibroid Embolization Trial. J Vasc Interv Radiol 14:1243–1250PubMed Pron G, Mocarski E, Bennett J, et al (2003) Tolerance, hospital stay, and recovery after uterine artery embolization for fibroids: The Ontario Uterine Fibroid Embolization Trial. J Vasc Interv Radiol 14:1243–1250PubMed
20.
Zurück zum Zitat Razavi MK, Hwang G, Jahed A, et al (2003) Abdominal myomectomy versus uterine fibroid embolization in the treatment of symptomatic uterine leiomyomas. AJR Am J Roentgenol 180:1571–1575PubMed Razavi MK, Hwang G, Jahed A, et al (2003) Abdominal myomectomy versus uterine fibroid embolization in the treatment of symptomatic uterine leiomyomas. AJR Am J Roentgenol 180:1571–1575PubMed
21.
Zurück zum Zitat Garry R, Fountain J, Brown J, et al (2004) EVALUATE hysterectomy trial: A multicentre randomised trial comparing abdominal, vaginal and laparoscopic methods of hysterectomy. Health Technol Assess 8:1–154PubMed Garry R, Fountain J, Brown J, et al (2004) EVALUATE hysterectomy trial: A multicentre randomised trial comparing abdominal, vaginal and laparoscopic methods of hysterectomy. Health Technol Assess 8:1–154PubMed
Metadaten
Titel
Pain and Return to Daily Activities after Uterine Artery Embolization and Hysterectomy in the Treatment of Symptomatic Uterine Fibroids: Results from the Randomized EMMY Trial
verfasst von
Wouter J.K. Hehenkamp
Nicole A. Volkers
Erwin Birnie
Jim A. Reekers
Willem M. Ankum
Publikationsdatum
01.04.2006
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 2/2006
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-005-0195-9

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