Evidence base: Uterine fibroids

A summary of the clinical trials, guidelines and key texts to help in the management of uterine fibroids.

Uterine fibroids: incidence increases with increasing age (Photograph: author image)
Uterine fibroids: incidence increases with increasing age (Photograph: author image)
  

Clinical trials

The largest observational study comparing the results of UAE carried out in large units throughout the UK and hysterectomy.

According to these researchers, UAE appears to be at least as safe as surgical treatment and the associated complication rates compare favourably with those for hysterectomy.

  • Randomised comparison of uterine artery embolisation (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST trial): 5-year results. BJOG 2011; 118: 936-44.

This trial demonstrates no significant differences between the two treatment modalities.

Symptom score reduction and patient satisfaction with either treatment were very high. Rates of adverse events were also similar in both groups.

However, the five-year intervention rate for treatment failure or complications was 32% for UAE and only 4% in the surgical arm.

Guidelines

Key texts

A comprehensive review covering the epidemiology, aetiology, pathogenesis and management of uterine fibroids.

A well-written review article on the management of uterine fibroids, with particular emphasis on the role of UAE in their management.

Curriculum
This topic falls under section 10.1 of the RCGP curriculum, Women's Health.


Contributed by Mr Farhad Alexander-Sefre, consultant gynaecological surgeon at the Glasgow Royal Infirmary


 


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