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Review
. 2007 Feb;53(2):250-6.

Uterine fibroid embolization: CME update for family physicians

Antony Raikhlin  1 , Mark Otto Baerlocher, Murray R Asch
Affiliations
Review

Uterine fibroid embolization: CME update for family physicians

Antony Raikhlin et al. Can Fam Physician. 2007 Feb.

Abstract
in English, French

Objective: To review evidence supporting the use of uterine fibroid embolization (UFE) as an alternative to hysterectomy and myomectomy for managing uterine fibroids.

Quality of evidence: MEDLINE was searched using the MeSH terms embolization, therapeutic; leiomyoma; treatment outcome; pregnancy; and clinical trials. Most published studies on use of UFE for management of uterine fibroids provide level II evidence.

Main message: For 71% to 92% of patients, UFE is effective at alleviating fibroid-related symptoms. After UFE, fibroids are reduced in size by 42% to 83%. Patients' satisfaction with the procedure is high (>90%), and UFE is safe and has a low rate of major complications (1.25%). When compared with hysterectomy, UFE is associated with fewer major complications, shorter hospital stays, and faster recovery. Although successful pregnancy following UFE is possible, there is insufficient evidence to advocate use of UFE over myomectomy for management of uterine fibroids in women wishing to preserve fertility.

Conclusion: For treatment of symptomatic uterine fibroids, UFE is a safe and effective nonsurgical alternative to hysterectomy and myomectomy.

OBJECTIF: Faire le point sur les données qui soutiennent l’utilisation de l’embolisation de l’artère utérine (EAU) comme alternative à l’hystérectomie et à la myomectomie pour traiter les fibromes utérins.

QUALITÉ DES PREUVES: Une recherche a été faite dans MEDLINE à l’aide des termes MeSH embolization; therapeutic; leimyoma; treatment outcome; pregnancy; et clinical trials. La plupart des études publiées fournissent des preuves de niveau II.

PRINCIPAL MESSAGE: Dans 71 à 92 % des cas, l’EAU est efficace pour soulager les symptômes dus aux fibromes. L’EAU entraîne une réduction de 42 à 83% de la taille des fibromes. Le taux de satisfaction chez les patientes traitées à l’EAU est élevé (>90 %) et ce traitement est sécuritaire, comportant très peu de complications majeures (1,25 %). En comparaison avec l’hystérectomie, l’EAU s’accompagne de moins de complications majeures, d’un séjour hospitalier plus court et d’une guérison plus rapide. Bien qu’une grossesse à terme soit possible après une EAU, il n’y a pas suffisamment de preuves pour préconiser cette technique de préférence à la myomectomie chez les patientes qui désirent conserver leur fertilité.

CONCLUSION: Dans le traitement des fibromes utérins symptomatiques, l’EAU est une méthode efficace qui représente une alternative non chirurgicale sécuritaire à l’hystérectomie et à la myomectomie.

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References

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