Uterine artery embolization is a relatively non-invasive procedure to stop the blood supply to the existing uterine fibroids in order to eliminate them. It involves a catheter through the artery and lasts for about an hour, but after the procedure, the uterus is intact. The fibroids do not have blood to feed them, so they disappear. But is it really a better solution than the hysterectomy, given that the symptomatic uterine fibroids may return within a year or two, and that with hysterectomy they cannot return because the uterus isn’t there any more?
Here’s a comparative study, with the full name of
Uterine artery embolisation or hysterectomy for the treatment of symptomatic uterine fibroids: a cost-utility analysis of the HOPEFUL study
by Wu, O. and Briggs, A.H. and Dutton, S. and Hirst, A. and Maresh, M. and Nicholson, A. and McPherson, K. (2007), and published in BJOG: An International Journal of Obstetrics and Gynaecology 114(11):pp. 1352-1362.
They wanted to see which procedure should be favourized from the standpoint of UK NHS. There were 649 women who underwent UAE (Uterine Artery Embolisation) and were followed for the 8.6 years in average, while there were 459 women with hysterectomy, which were followed for up to 4.6 in average.
Two main measures were the Costs of procedures and complications, and Quality Adjusted Life Years (QALY) UAE had the lower cost, £2536 versus £3282, small reduction in quality of life (8.203 versus 8.241 QALYs) when compared with hysterectomy. However, when the quality of life associated with the conservation of the uterus was incorporated in the model, UAE was shown to be the dominant strategy—lower costs and greater QALYs.
The result of the study is that simply more women should be allowed to UAE instead of going directly to hysterectomy. This is especially important if the woman wants to preserve her uterus.
The abstract of the Uterine Artery Embolisation or Hysterectomy For the Treatment of Symptomatic Uterine Fibroids study is published by the University of Glasgow.