Quality of Life Assessment After Uterine Artery Embolization in Patients with Fibroids Treated in an Ambulatory Setting.

Abstract

Background: Despite the growing acceptance of uterine artery embolization (UAE) to treat women with fibroid disease, its wider use remains limited because it is not considered to be a definitive therapy, as opposed to surgical treatments such as myomectomy or hysterectomy. Given the evolution of health care towards outpatient medicine, it is critical to determine the impact of UAE on the quality of life (QoL) of women with fibroid disease treated in an outpatient setting. Objectives: The purpose of this study was to assess the QoL of patients with fibroids treated with UAE in an office-based lab setting. Study Design: This prospective single-arm study was approved by the western IRB (wIRB) and included 1285 consecutive patients-the largest study on UAE to date-enrolled from September 2021 to December 2023 who were seen for a baseline evaluation in a clinic and then, subsequently, between 2 and 8 months post-UAE for follow-up clinical and imaging evaluation. Patient QoL was assessed using the validated QoL questionnaire: the Uterine Fibroid Symptom and Health-Related Quality of Life questionnaire. Results: The results from all 1285 patients were analyzed. The median and mean follow-up periods were 182 and 180 days, respectively (interquartile range of 19 days). UAE led to reduced bleeding in 96% of patients, pelvic pain and bulk-related symptoms in 94%, fatigue in 94%, and urination frequency in 92%. On the other hand, improvements were seen in the level of activity in 82%, energy and mood in 85%, and sexual function in 71% of the patients, whereas the general QoL index significantly increased in 86% of the patients (p < 0.001). More than one third of our patients (39%) had Medicaid insurance, reflecting the relatively low socioeconomic status of our patient population. Conclusions: In this largest clinical trial on UAE to date, we found that performing UAE in an outpatient setting significantly improved patients' clinical symptoms such as bleeding and bulk symptoms and, most importantly, their overall QoL.