Uterine artery embolization versus myomectomy: impact on quality of life--results of the FUME (Fibroids of the Uterus: Myomectomy versus Embolization) Trial.

PURPOSE

This study was designed to compare quality of life (QoL) outcomes after uterine artery embolization (UAE) or myomectomy.

METHODS

Women with symptomatic fibroids diagnosed by ultrasound who wished to preserve their uterus were randomized to myomectomy (n=81) or UAE (n=82). Endpoints at 1 year were QoL measured by a validated questionnaire, hospital stay, rates of complications, and need for reintervention.

RESULTS

UAE patients had shorter hospitalization (2 vs. 6 days, p<0.001). By 1 year postintervention, significant and equal improvements in QoL scores had occurred in both groups (myomectomy n=59; UAE n=61). There had been two (2.9%) major complications among UAE versus 6 (8%) among myomectomy patients (not significant). By 2 years, among UAE patients (n=57) there were eight (14.0%) reinterventions for inadequate symptom control compared with one (2.7%) among myomectomy patients (n=37). Half of the women who required hysterectomy had concomitant adenomyosis missed by US.

CONCLUSIONS

UAE and myomectomy both result in significant and equal improvements in QoL. UAE allows a shorter hospital stay and fewer major complications but with a higher rate of reintervention.