Document Detail


Uterine artery embolization versus laparoscopic occlusion of uterine arteries for leiomyomas: long-term results of a randomized comparative trial.
MedLine Citation:
PMID:  19713130     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To compare long-term symptom recurrence and 6-month magnetic resonance (MR) imaging results after two different treatments for uterine leiomyomas. MATERIALS AND METHODS: Sixty-six women with uterine leiomyomas were randomized to undergo uterine artery embolization (UAE) or laparoscopic bilateral occlusion of uterine arteries. Contrast-enhanced MR imaging was performed before treatment and after 6 months. RESULTS: Fifty-eight patients received treatment. Median follow-up time was 48 months (range, 8-73 months). Clinical failure and symptom recurrence occurred in 14 patients after laparoscopy (48%) and in five after UAE (17%; P = .02, log-rank test). Hysterectomy was performed in two patients after UAE (7%) and in eight after laparoscopy (28%; P = .041). Six-month MR imaging results were available for 26 patients treated with UAE and 22 treated with laparoscopy. The mean uterine volume was reduced by 51% (range, 16%-86%) after UAE treatment, compared with 33% (range, 6%-77%) after laparoscopy (P = .001). Complete leiomyoma infarction was seen in all 26 patients in the UAE group and in only five patients in the laparoscopy group (P < .001). Eleven patients experienced symptom recurrence later than 6 months. Uterine volume reduction at 6 months was 24% in this group, compared with 48% in the 37 patients with no recurrence (P = .004). Incomplete infarction of leiomyomas was seen in eight of the 11 cases of recurrence (73%) versus nine of 37 cases without recurrence (24%; P = .009). CONCLUSIONS: Recurrence rate was significantly lower after UAE than after laparoscopic treatment. Larger volume reduction and more complete devascularization of leiomyomas were found after UAE treatment and among patients with no recurrence.
Authors:
Kirsten Hald; Hans J??rgen Noreng; Olav Istre; Nils-Einar Kl??w
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2009-08-26
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  20     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-05     Completed Date:  2010-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1303-10; quiz 1311     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Ullev??l, Oslo University Hospital, Oslo, Norway. khald@online.no
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Humans
Laparoscopy / methods*
Leiomyoma / diagnosis*,  therapy*
Longitudinal Studies
Treatment Outcome
Uterine Artery Embolization / methods*
Uterine Neoplasms / diagnosis*,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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