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.
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Jointly provided by
