Uterine Artery Embolization versus Abdominal Myomectomy: A Long-term Clinical Outcome Comparison

PURPOSE: To assess long-term clinical effectiveness of uterine artery embolization (UAE) compared with abdominal myomectomy. MATERIALS AND METHODS: Women who received UAE (n = 87) or abdominal myomectomy (n = 98) for symptomatic uterine leiomyomata between 2000 and 2002 at a single institution were consecutively enrolled in this study. Patients whose procedures were performed within 5 years before the study were included. Symptom evaluations with symptom severity scores, pregnancy rates, and satisfaction with the procedures were obtained via institutional review board approved questionnaires. Chart reviews were performed to supplement analyses. RESULTS: The retrospective cohort included 185 patients, of whom long-term follow-up was completed by 89 patients (48.1%), 48 being treated with UAE, and 41 with myomectomy. Follow-up ranged from 50 to 83 months. A higher but not statistically significant number of patients received repeat interventions after abdominal myomectomy (14%) versus UAE (8%; P = .204). Significantly higher symptom severity score improvements were seen in patients treated with UAE versus abdominal myomectomy (34 vs 31; P = .02). UAE recipients were less likely to attempt to get pregnant (P = .02), but those who did had a 66.7% success rate compared with 58.8% for patients who underwent myomectomy. Similar numbers of patients between groups were satisfied with the procedure (P = .57), reported effectiveness of symptom relief (P = .43), and would recommend the procedure to others (P = .37). CONCLUSIONS: UAE results in long-term clinical success with outcomes comparable or superior to those of abdominal myomectomy.