- A multicentre retrospective cohort study comparing hysterectomy and uterine artery embolisation for the treatment of symptomatic uterine fibroids (HOPEFUL study): main results on medium-term safety and efficacy.
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.
- NICE. Heavy menstrual bleeding. CG44. NICE, 2007, London. www.guidance.nice.org.uk/CG44/NICEGuidance/pdf/English
- Stewart EA. Uterine fibroids. Lancet 2001; 357: 293-8.
A comprehensive review covering the epidemiology, aetiology, pathogenesis and management of uterine fibroids.
- Lumsden MA. Modern management of fibroids. Obstet Gynaecol Reprod Med 2010; 20: 82-6.
A well-written review article on the management of uterine fibroids, with particular emphasis on the role of UAE in their management.
- Uterine artery embolization for symptomatic uterine fibroids. Cochrane Database Syst Rev 2006; (1): CD005073.
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