1. Rosenberg, Karen


According to this study:


* Women with symptomatic uterine fibroids report better health-related quality of life after myomectomy compared with those who had uterine-artery embolization.



Article Content

Myomectomy and uterine-artery embolization are treatment options for women with uterine fibroids. Long-term outcomes data comparing these procedures are lacking. In a multicenter, randomized trial, researchers compared the effects of these treatments on quality of life in women who had symptomatic uterine fibroids and wanted to avoid hysterectomy.


Women who were older than age 18, were premenopausal, had symptomatic fibroids that could be treated with either myomectomy or uterine-artery embolization, and were not pregnant were eligible for the study. A total of 254 women were randomly assigned to one of the two procedures. Data on the primary outcome-fibroid-related quality of life, as assessed by a score on the health-related quality-of-life domain of the Uterine Fibroid Symptom and Quality of Life questionnaire-at two years were available for 206 of these women. Baseline characteristics and severity and distribution of fibroids were similar in the two groups.


At two years, mean scores on the health-related quality-of-life domain for both groups were substantially higher than at baseline. Although all women reported a better quality of life, women who underwent myomectomy had greater improvement than those who underwent uterine-artery embolization. The incidence of complications was low in both groups: 24% in the uterine-artery embolization group and 29% in the myomectomy group. Among the women for whom data were available at two years, additional fibroid-related procedures were performed in 7% of those who had myomectomy and 16% of those who had embolization.


In this study, some of the participants didn't receive the intervention they were assigned, and 19% didn't complete the primary outcome questionnaire at two years. Other limitations include the fact that the study wasn't blinded.


Manyonda I, et al N Engl J Med 2020;383(5):440-51.