Insights into Imaging (Jun 2022)

Short- and long-term evaluation of disease-specific symptoms and quality of life following uterine artery embolization of fibroids

  • Iason Psilopatis,
  • Florian Nima Fleckenstein,
  • Federico Collettini,
  • Elif Can,
  • Anne Frisch,
  • Bernhard Gebauer,
  • Uli Fehrenbach,
  • Giovanni Federico Torsello,
  • Dirk Schnapauff,
  • Matthias David,
  • Gero Wieners

DOI
https://doi.org/10.1186/s13244-022-01244-1
Journal volume & issue
Vol. 13, no. 1
pp. 1 – 10

Abstract

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Abstract Background The purpose of this study is to evaluate uterine artery embolization (UAE) for the management of symptomatic uterine leiomyomas regarding changes in quality of life after treatment in a large patient collective. This study retrospectively analyzed prospectively acquired standardized questionnaires of patients treated with UAE. Clinical success was evaluated before and after embolization. Patients were stratified into short- (≤ 7 months) and long-term (> 7 months) follow-up groups depending on the time of completion of the post-interventional questionnaire. Uterine leiomyomas were furthermore divided into small (< 10 cm) and large (≥ 10 cm) tumors based on the diameter of the dominant fibroid. Results A total of 245 patients were included into the final data analysis. The Kaplan–Meier analysis showed a cumulative clinical success rate of 75.8% after 70 months until the end of follow-up (9.9 years). All questionnaire subscales showed a highly significant clinical improvement from baseline to short- and long-term follow-up (p < 0.001). Patients with small fibroids showed a significantly better response to UAE in multiple subcategories of the questionnaire than patients with fibroids ≥ 10 cm who had a twofold higher probability of re-intervention in the Cox-regression model. Conclusions UAE is an effective treatment method for symptomatic fibroids that leads to quick relief of fibroid-related symptoms with marked improvement of quality of life and is associated with a low risk for re-interventions. Patients with small fibroids tend to show a better response to UAE compared to patients with large fibroids. Trial registration Charité institutional review board, EA4/167/20. Registered 27 November 2020—Retrospectively registered. https://ethikkommission.charite.de/

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