The Ontario Uterine Fibroid Embolization Trial. Part 2. Uterine fibroid reduction and symptom relief after uterine artery embolization for fibroids☆

Received 19 April 2002; received in revised form 16 September 2002; accepted 16 September 2002.

Abstract

Objective

To evaluate fibroid uterine volume reduction, symptom relief, and patient satisfaction with uterine artery embolization (UAE) for symptomatic fibroids.

Design

Multicenter, prospective, single-arm clinical treatment trial.

Setting

Eight Ontario university and community hospitals.

Patient(s)

Five hundred thirty-eight patients undergoing bilateral UAE.

Intervention(s)

Bilateral UAE performed with polyvinyl alcohol particles sized 355–500 μm.

Main outcome measure(s)

Three-month follow-up evaluations including fibroid uterine volume reductions, patient reported symptom improvement (7-point scale), symptom life-impact (10-point scale) reduction, and treatment satisfaction (6-point scale).

Result(s)

Median uterine and dominant fibroid volume reductions were 35% and 42%, respectively. Significant improvements were reported for menorrhagia (83%), dysmenorrhea (77%), and urinary frequency/urgency (86%). Mean menstrual duration was significantly reduced after UAE (7.6 to 5.4 days). Improvements in menorrhagia were unrelated to pre-UAE uterine size or post-UAE uterine volume reduction. Amenorrhea occurring after the procedure was highly age dependent, ranging from 3% (1%–7%) in women under age 40 to 41% (26%–58%) in women age 50 or older. Median fibroid life-impact scores were significantly reduced after UAE (8.0 to 3.0). The majority (91%) expressed satisfaction with UAE treatment.

Conclusion(s)

UAE reduced fibroid uterine volume and provided significant relief of menorrhagia that was unrelated to initial fibroid uterine size or volume reduction. Patient satisfaction with short-term UAE treatment outcomes was high.

Keywords: Uterine artery embolization, fibroids, leiomyoma, polyvinyl alcohol particles, menorrhagia, amenorrhea, treatment effectiveness, clinical study

a Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada

b Center for Research in Women’s Health, Sunnybrook and Women’s College Health Sciences Center, Toronto, Ontario, Canada

c Department of Radiology, St. Joseph’s Health Care, London, Ontario, Canada

d Department of Medical Imaging, St. Michael’s Hospital, Toronto, Ontario, Canada

e Department of Medical Imaging, Mount Sinai Hospital, Toronto, Ontario, Canada

f Department of Medical Imaging, Toronto General Hospital, Toronto, Ontario, Canada

Reprint requests: Gaylene Pron, Ph.D., Department of Public Health Sciences, Faculty of Medicine, University of Toronto, 100 College St., Room 513, Banting Building, Toronto, Ontario M5G 1L5, Canada (FAX: 416-971-2240).

☆ The Ontario Uterine Fibroid Embolization Trial was funded in part by the Boston Scientific Corporation.

PII: S0015-0282(02)04538-7

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