Myomectomy bests uterine artery embolization for treating uterine Fibroids: NEJM study
Researchers have found in a randomized trial that women with symptomatic uterine fibroids reported significantly better quality of life (QoL) following myomectomy as compared with uterine artery embolization. The findings of the study have been reported in the New England Journal of Medicine.
Uterine fibroids are most common type of tumor among women of reproductive age.They are associated with heavy menstrual bleeding, abdominal discomfort, subfertility, and a reduced quality of life. For women who wish to preserve their uterus and who have not had a response to medical treatment, myomectomy and uterine-artery embolization are therapeutic options.
The researchers conducted a multicenter, randomized, open-label trial to evaluate myomectomy, as compared with uterine-artery embolization, in women who had symptomatic uterine fibroids and did not want to undergo hysterectomy. Procedural options included open abdominal, laparoscopic, or hysteroscopic myomectomy. Moreover some women want an alternative to hysterectomy for various other reasons, such as maintenance of body integrity and shorter recovery time.
The primary outcome was fibroid-related quality of life, as assessed by the score on the health-related quality-of-life domain of the Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaire (scores range from 0 to 100, with higher scores indicating a better quality of life) at 2 years; adjustment was made for the baseline score.
In head to head comparison both fibroid-specific and health-related QoL improved more with myomectomy, although scores for both treatment groups improved from baseline. Scores related to symptom severity favored myomectomy at 6 months and 2 years. Menstrual bleeding scores were similar in the two groups.In addition to this few intraoperative complications occurred in either group, and rates of perioperative/postoperative complications were similar.
The trial has provided new information for clinicians and their patients who want to retain the option for reproduction.
The researchers concluded that among women with symptomatic uterine fibroids, those who underwent myomectomy had a better fibroid-related quality of life at 2 years than those who underwent uterine-artery embolization.
For further reference log on to:
New England Journal of Medicine
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as an Editor-in-Chief for the Speciality Medical Dialogues section. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Before Joining Medical Dialogues, he has served at important positions in the medical industry in India including as the Hony. Secretary of the Delhi Medical Association as well as the chairman of Anti-Quackery Committee in Delhi and worked with other Medical Councils in India. Email: firstname.lastname@example.org. Contact no. 011-43720751