Uterine fibroid embolization: An analysis of clinical outcomes and impact on patients' quality of life.

Abstract

Background: Uterine fibroids (UF) affect up to 70-80% of women by age 50 and are associated with heavy menstrual bleedings, pelvic discomfort, and reduced quality of life. Uterine artery embolization (UAE) is a minimally invasive procedure that aims to reduce fibroid-related symptoms and improve patients' quality of life.

Materials and methods: A prospective single-center study was conducted on 40 women who underwent UAE between November 2018 and June 2023. Primary outcomes were evaluated using the Uterine Fibroid Symptom and Quality-of-Life (UFS-QoL) questionnaire to assess symptom severity and health-related quality-of-life scores. Secondary outcomes include pain intensity, complications, requirement of additional treatments, and duration of symptoms after discharge.

Results: Thirty-three patients completed the follow-up UFS-QoL questionnaire. The mean age and the mean follow-up time were 47 years (SD 14 years) and 10 months (SD 4 months), respectively. Substantial improvements were observed within all domains of the UFS-QoL questionnaire (p < 0.001), particularly in symptom severity, where 94% of patients experienced a benefit. All Health Related Quality-of-Life (HRQL) domains statistically significantly improved (73-91%; p < 0.001). 67% of patients did not require further treatments. Pelvic pain, according to VAS, improved by 2.1 (0 = much better; 5 = no change; 10 = worse). Post-procedural complications were minor, 70% of patients reported symptoms persisted up to 5 days after discharge, and 88% resolved within 2 weeks. Despite a 45.5% rate of minor complications, including pain and transitory bleeding, 88% of patients would recommend UAE, underlining its safety and effectiveness.

Discussion and conclusion: UAE offers substantial benefits for symptomatic fibroids, significantly improving HRQoL, symptom severity and pelvic pain scores, making it a valuable alternative to surgery. Complications were minor and short-lived, and the majority of patients were satisfied with the results, with no need for additional treatments. Further research is warranted to generate peri-procedural pain management consensus guidelines, clinical outcomes of radial access, and fertility-related outcomes.