Evaluation of the Efficacy and Complications of Uterine Artery Embolization in Comparison with Laparotomy-Myomectomy in the Treatment of Uterine Myomas: A Randomized Clinical Trial

Allameh, Zahra; Afzali, Soheila; Jafarpisheh, Mohamadsaleh; Movahedi, Minoo; Seresht, Leila Mousavi

doi:10.47176/mjiri.36.87

Cited by 3 publications

(7 citation statements)

References 26 publications

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“…After the removal of duplicates, reviews and case reports, 1124 results remained for title and abstract screening, resulting in the selection of 55 studies for full-text assessment. Of these, 17 published papers including thirteen cohort studies [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] met the de ned inclusion criteria and compared the UAE and MYO groups. Fig.…”

Section: Resultsmentioning

confidence: 99%

“…The Table 1 presented the characteristics of the included studies, which comprised of four RCTs [14][15][16][17][18][19][20][21] , two prospective cohorts 22,28 and seven retrospective studies. [23][24][25][26][27]29,30 The sample size of the studies ranged from 80 to 18433 participants.…”

Section: Resultsmentioning

confidence: 99%

“…35 Yet the pooled hospital-stay result exhibits high heterogeneity (I 2 = 87%) in Table 3. A sensitivity analysis, omitting the poorer designed study, 21 found that UAE stays remain signi cantly shorter than MYO's (MD, -47.98; 95% CI, -48.80 to -47.17; P < 0.01; heterogeneity: I 2 = 0%). For readmissions, Amoah 24 reported a bigger discrepancy in MYO vs. UAE.…”

Section: Early Outcomesmentioning

confidence: 92%

“…The analysis of the original data revealed that the incidence of abnormal uterine bleeding was improved from pre-operation to post-operation 16,21 , such as amenorrhea (0.4% to 17.2%), light (1.4% to 42.5%), normal (30.9% to 29.3%) and heavy (67.4% to 12.1%). However, the synthesized outcomes indicated that there was no signi cant difference between the UAE group and the MYO group in terms of amenorrhea (OR, 0.80; 95% CI, 0.35 to 1.84, P = 0.60; Heterogeneity: I² = 0%), light (OR, 1.83; 95% CI, 0.58 to 5.80, P = 0.31; Heterogeneity: I² = 0%), normal (OR, 0.50; 95% CI, 0.05 to 4.72, P = 0.55; Heterogeneity: I² = 59%) and heavy (OR, 0.96; 95% CI, 0.38 to 2.42; P = 0.93; Heterogeneity: I² = 0%) at the end of follow-up (Table 5).…”

Section: Abnormal Uterine Bleedingmentioning

confidence: 99%

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Systematic review and meta-analysis of current evidence in uterine artery embolization vs myomectomy for symptomatic uterine fibroids

Peng,

Wang,

Shu

et al. 2024

Preprint

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Purpose This review compares the efficacy of Uterine Artery Embolization (UAE) and Myomectomy (MYO) in managing symptomatic Uterine Fibroids (UFs) in women who do not want hysterectomy. Materials and Methods A meta-analysis was performed on all relative studies. Outcomes evaluated reintervention, UFs scores for quality of life (QOL) and symptom severity, and so on. To determine mean differences (MDs) or odds ratios (ORs) with 95% confidence intervals (CIs), a random or fixed-effects model was utilized. Results A meta-analysis of 13 studies (9 observational and 4 randomized controlled trials) was conducted. The results indicated that UAE had a higher reintervention rate (OR, 1.84; 95% CI, 1.62 to 2.10; P < 0.01; I² = 39%), hysterectomy rate (OR, 4.04; 95% CI, 3.45 to 4.72; P < 0.01; I² = 59%), and symptom-severity score (OR, -4.02; 95% CI, 0.82, 7.22; P = 0.01; I² = 0%) compared to MYO at a four-year follow-up. However, UAE was associated with a lower rate of early complications (OR, 0.44; 95% CI, 0.20 to 0.95; P = 0.04; I² = 25%), and readmission rate (OR, 1.16; 95% CI, 1.01 to 1.33; P = 0.04; I² = 0%) compared to MYO. Furthermore, both procedures had comparable improvement in pregnancy rates and abnormal uterine bleeding. Conclusion In conclusion, UAE and MYO are effective in treating symptomatic UFs but they have different outcomes. The decision on which procedure to choose should be made based on individual preferences and the physician's expertise.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Early Outcomesmentioning

confidence: 92%

Section: Abnormal Uterine Bleedingmentioning

confidence: 99%

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Systematic review and meta-analysis of current evidence in uterine artery embolization vs myomectomy for symptomatic uterine fibroids

Peng,

Wang,

Shu

et al. 2024

Preprint

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“…Thanks to its minimal invasiveness, UAE has been demonstrated to be superior in terms of shorter hospital stays, anesthetic drug administration, and earlier return to normal activities compared to surgery [ 27 ]. In addition to the obvious clinical advantage, these results are of the utmost importance also for the cost-effectiveness of uterine fibroids management.…”

Section: Introductionmentioning

confidence: 99%

Uterine Artery Embolization for the Treatment of Symptomatic Uterine Fibroids of Different Sizes: A Single Center Experience

Cappelli

Mosconi

Cocozza

et al. 2023

JPM

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The present study aimed to evaluate the clinical and radiological 1-year outcomes of uterine artery embolization (UAE) performed in a selected population of women with symptomatic myomas and who do not wish to conceive. Between January 2004 and January 2018, a total of 62 patients with pre-menopausal status and with no wish to conceive in the future underwent UAE for the treatment of symptomatic fibroids. All the patients underwent magnetic resonance imaging (MRI) and/or transvaginal ultrasonography (TV-US) before and after the procedure at 1-year follow-up. Clinical and radiological parameters were recorded, stratifying the population into 3 groups according to the size of the dominant myoma (group 1: <50 mm; group 2: ≥50 and ≤80 mm; group 3: >80 mm). Mean fibroid diameter was significantly reduced (42.6% ± 21.6%) at 1-year follow-up, with excellent improvements in terms of both symptoms and quality of life. No significant difference was observed regarding baseline dimension and the number of myomas. No major complications were reported (2.5%). The present study confirms the safety and efficacy of UAE in the treatment of symptomatic fibroids in pre-menopausal women with no desire to conceive.

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Surgical Management of Uterine Fibroids at the Teaching Hospital of Angre Abidjan Cote d’Ivoire: 193 Cases Report

Eléonore¹,

Houphouet-Mwandji²,

Effoh³

et al. 2023

Clin J Obstet Gynecol

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Objective: To evaluate the surgical management of myomas at the Teaching Hospital of Angré according to the FIGO (International Federation of Gynecology and Obstetrics) classification. Patients and methods: This was a cross-sectional study at the Teaching Hospital of Angre from January 1, 2020, to December 31, 2022. Patients whose operative indication was clearly identified were included in the study. Incomplete files were not included. The variables studied were anthropometric parameters, clinical characteristics of myomas, and surgery. Due to the large size and multifocal location of uterine myomas, the therapeutic option remained surgery by laparotomy. Results: Most patients were over 35 years old (71.5%) and nulliparous (52.8%). The first indication for surgery was menometrorrhagia (88.6%), followed by the desire for motherhood (37.8%) and dysmenorrhoea (20.2%) for myomas most often FIGO type 4 (p = 0.0031). Myomectomy under cervical-isthmic tourniquet was the most common procedure for FIGO type 4 myomas (66.1%; p = 0.0543). Hysterectomy was most frequently performed for FIGO type 7 myomas (43.9%; p = 0.0543). For myomectomy, the first complication was anaemia (3.5%) followed by uterine suture haemorrhage (1.7%) (p = 0.5139). Conclusion: Our surgical practice at the Teaching Hospital of Angre is in accordance with FIGO recommendations. However, an effort should be made to promote the minimally invasive surgical approach (laparoscopic, hysteroscopic, transvaginal ablation) for small fibroids (≤ 5 cm) or FIGO type 0 to 3, which is not very frequent in our current practice.

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Evaluation of the Efficacy and Complications of Uterine Artery Embolization in Comparison with Laparotomy-Myomectomy in the Treatment of Uterine Myomas: A Randomized Clinical Trial

Cited by 3 publications

References 26 publications

Systematic review and meta-analysis of current evidence in uterine artery embolization vs myomectomy for symptomatic uterine fibroids

Systematic review and meta-analysis of current evidence in uterine artery embolization vs myomectomy for symptomatic uterine fibroids

Uterine Artery Embolization for the Treatment of Symptomatic Uterine Fibroids of Different Sizes: A Single Center Experience

Surgical Management of Uterine Fibroids at the Teaching Hospital of Angre Abidjan Cote d’Ivoire: 193 Cases Report

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