Uterine Artery Embolization or Focused Ultrasound for Uterine Fibroids?
This study by Barnard et al. (AJOG, 2017) compares outcomes of uterine artery embolization and magnetic resonance imaging-guided focused ultrasound for treatment of uterine fibroids.
Randomized Controlled Trail (RCT)
57 premenopausal women with symptomatic uterine fibroids were enrolled in the RCT from 3 different academic institutions. 34 women who did not want to undergo randomization were included in a parallel non-randomized study. Medication use, symptoms, return to work and normal activities, and adverse events were recorded in the post-procedure diaries for 6 weeks. Mean procedure times were longer in the focused ultrasound surgery group vs. embolization (405 vs 139 min; P <.001). Self-rated pain immediately following the procedure was higher in the uterine artery embolization cohort vs. focused ultrasound (P = .002). This pain differential was also reflected post-op with increased outpatient opioid use in the embolization group (75% vs 21%; P < .001), as well as use of nonsteroidal anti-inflammatory medications (97% vs 67%; P < .001). The embolization also reported more days off work, (8 vs 4 days; P < .001) as well as days until return to normal (15 vs 10 days; P = .02). Results were similar whether the entire study population or only the RCT arm was analyzed. The authors conclude that focused ultrasound may take longer but recovery and pain control were better compared to embolization.
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