NEW YORK (Reuters Health) – In the short term, uterine artery embolization (UAE) for symptomatic uterine fibroids has advantages over hysterectomy or myomectomy in terms of faster recovery, and thereafter health-related quality of life is similar with all approaches, results of a meta-analysis show.

Dr. Sanne M. van der Kooij and colleagues with the Academic Medical Center, Amsterdam, the Netherlands, and colleagues identified four randomized clinical trials comparing UAE to hysterectomy/myomectomy in 515 women.

As the authors note in a March 17 online issue of the American Journal of Obstetrics and Gynecology, the relatively low uptake of UAE may be due to uncertainty about long-term efficacy. Their review and analysis therefore focused on results up to 5 years.

The team found that the UAE procedure was significantly shorter than both hysterectomy and myomectomy, and procedural blood loss was significantly less with UAE (31 mL) compared with hysterectomy (436 mL). Length of stay was significantly shorter with UAE than hysterectomy or myomectomy (60.2 hours vs 86.1 hours).

However, readmission rates during the first 6 months after the procedures were higher with UAE than after surgical procedures. Also, at 1, 2 and 5 years after the procedures, there were significantly more re-intervention in the UAE group than the hysterectomy group. For example, at 5 years the odds ratio for re-intervention for UAE vs hysterectomy was 5.41.

Nonetheless, at all time points, health-related quality of life did not differ between the UAE and surgical groups, and women in both groups were equally satisfied, Dr. van der Kooij and colleagues found.

“It is clear that UAE has good outcomes on the short term, thereby resulting in a similar complication rate and similar health-related quality of life scores and satisfaction rates when compared to hysterectomy, even on the long term, despite a high percentage of re-interventions,” they conclude. “In view of these findings, UAE deserves a place in the therapeutic arsenal for symptomatic uterine fibroids.”

Am J Obstet Gynecol 2011.