The Outcome of Uterine Artery Embolization in the Treatment of Uterine Leiomyomas in Mongolia

Abstract

Objective: To evaluate and determine treatment efficacy of uterine artery embolization versus uterine myomectomy in treating uterine leiomyomas. Methods: In 2010-2013, 94 women between the ages of 23-50 years were recruited in the study. They were divided into 2 treatment groups: uterine artery embolization and myomectomy (control) group and were followed up for two consecutive years. Results: After uterine artery embolization, the volume of leiomyomas decreased 56%-91% (p<0.05). Menorrhagia in the uterine artery embolization versus myomectomy group was 95.2% and 92.8% (p>0.05), anemia 87.5% and 85.7% (p>0.05), pain subsided 72.2% versus 86.8% and "bulk" symptoms 87.5% versus 100% respectively (p>0.05). Overall health-related quality of life score +27.6 versus +17.1 and SS score -34.0 versus -32.8, patient satisfaction 89.4% versus 72.3% (p=0.001). Re-growth after uterine artery embolization 2.1% versus myomectomy 23.4% (p=0.0001), Post-treatment conception 25.5% versus 31.9% and cesarean delivery rate 88.9% versus 90% respectively (p>0.05). Duration of the procedure 38.9±4.8 minutes versus 54.0±26.3 minutes (p=0.0001), length of hospital stay 2.4±0.9 days versus 6.9±2.3 days (p=0.0001), days to recovery 10.6±3.0 versus 26.2±17.9 (p=0.0001). Conclusion: Uterine artery embolization treatment effectively decreases the size of leiomyomas (p=0.015), it particularly improves menorrhagia. The quality of life and patient satisfaction scores after uterine artery embolization are better (p=0.001). There was no statistically significant difference with regard to conception rate or the need for cesarean delivery (p>0.05).