Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids (EMMY trial): peri- and postprocedural results from a randomized controlled trial

Wouter J K Hehenkamp; Nicole A Volkers; Peter F J Donderwinkel; Sjoerd de Blok; Erwin Birnie; Willem M Ankum; Jim A Reekers

doi:10.1016/j.ajog.2005.05.017

Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids (EMMY trial): peri- and postprocedural results from a randomized controlled trial

Wouter J K Hehenkamp, Nicole A Volkers, Peter F J Donderwinkel, Sjoerd de Blok, Erwin Birnie, Willem M Ankum, Jim A Reekers

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: This was a randomized controlled trial to evaluate the safety of uterine artery embolization (UAE) compared with hysterectomy.

STUDY DESIGN: Twenty-eight Dutch hospitals recruited 177 patients with symptomatic uterine fibroids and menorrhagia who were eligible for hysterectomy. Patients were randomized to UAE (n = 88) or hysterectomy (n = 89). In this paper we evaluate the peri- and postprocedural complications, length of hospital stay, unscheduled visits, and readmission rates up to 6 weeks' post-intervention. Analysis was by intention to treat.

RESULTS: Bilateral UAE failure occurred in 4 patients (4.9%). Major complications occurred in 4.9% (UAE) and 2.7% (hysterectomy) of cases (P = .68). The minor complication rate from discharge until 6 weeks after was significantly higher in the UAE group than in the hysterectomy group (58.0% vs 40.0%; RR 1.45 [1.04-2.02]; P = .024). UAE patients were more often readmitted (11.1% vs 0%; P = .003). Total length of hospital stay was significantly shorter in UAE patients (mean [SD]: 2.5 [2.7] vs 5.1 [1.3], P < .001).

CONCLUSION: UAE is a procedure similar to hysterectomy with a low major complication rate and with a reduced length of hospital stay. Higher readmission rates after UAE stress the need for careful postprocedural follow-up.

Original language	English
Pages (from-to)	1618-29
Number of pages	12
Journal	American Journal of Obstetrics and Gynecology
Volume	193
Issue number	5
DOIs	https://doi.org/10.1016/j.ajog.2005.05.017
Publication status	Published - Nov 2005

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10.1016/j.ajog.2005.05.017

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Hehenkamp, W. J. K., Volkers, N. A., Donderwinkel, P. F. J., de Blok, S., Birnie, E., Ankum, W. M., & Reekers, J. A. (2005). Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids (EMMY trial): peri- and postprocedural results from a randomized controlled trial. American Journal of Obstetrics and Gynecology, 193(5), 1618-29. https://doi.org/10.1016/j.ajog.2005.05.017

@article{5bfa6822545242878cc636c84683c351,

title = "Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids (EMMY trial): peri- and postprocedural results from a randomized controlled trial",

abstract = "OBJECTIVE: This was a randomized controlled trial to evaluate the safety of uterine artery embolization (UAE) compared with hysterectomy.STUDY DESIGN: Twenty-eight Dutch hospitals recruited 177 patients with symptomatic uterine fibroids and menorrhagia who were eligible for hysterectomy. Patients were randomized to UAE (n = 88) or hysterectomy (n = 89). In this paper we evaluate the peri- and postprocedural complications, length of hospital stay, unscheduled visits, and readmission rates up to 6 weeks' post-intervention. Analysis was by intention to treat.RESULTS: Bilateral UAE failure occurred in 4 patients (4.9%). Major complications occurred in 4.9% (UAE) and 2.7% (hysterectomy) of cases (P = .68). The minor complication rate from discharge until 6 weeks after was significantly higher in the UAE group than in the hysterectomy group (58.0% vs 40.0%; RR 1.45 [1.04-2.02]; P = .024). UAE patients were more often readmitted (11.1% vs 0%; P = .003). Total length of hospital stay was significantly shorter in UAE patients (mean [SD]: 2.5 [2.7] vs 5.1 [1.3], P < .001).CONCLUSION: UAE is a procedure similar to hysterectomy with a low major complication rate and with a reduced length of hospital stay. Higher readmission rates after UAE stress the need for careful postprocedural follow-up.",

keywords = "Adult, Arteries, Embolization, Therapeutic/adverse effects, Female, Follow-Up Studies, Hospitalization, Humans, Hysterectomy/adverse effects, Leiomyoma/surgery, Middle Aged, Postoperative Complications/epidemiology, Uterine Neoplasms/surgery, Uterus/blood supply",

author = "Hehenkamp, {Wouter J K} and Volkers, {Nicole A} and Donderwinkel, {Peter F J} and {de Blok}, Sjoerd and Erwin Birnie and Ankum, {Willem M} and Reekers, {Jim A}",

year = "2005",

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doi = "10.1016/j.ajog.2005.05.017",

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Hehenkamp, WJK, Volkers, NA, Donderwinkel, PFJ, de Blok, S, Birnie, E, Ankum, WM & Reekers, JA 2005, 'Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids (EMMY trial): peri- and postprocedural results from a randomized controlled trial', American Journal of Obstetrics and Gynecology, vol. 193, no. 5, pp. 1618-29. https://doi.org/10.1016/j.ajog.2005.05.017

Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids (EMMY trial) : peri- and postprocedural results from a randomized controlled trial. / Hehenkamp, Wouter J K; Volkers, Nicole A; Donderwinkel, Peter F J et al.

In: American Journal of Obstetrics and Gynecology, Vol. 193, No. 5, 11.2005, p. 1618-29.

Research output: Contribution to journal › Article › Academic › peer-review

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T1 - Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids (EMMY trial)

T2 - peri- and postprocedural results from a randomized controlled trial

AU - Hehenkamp, Wouter J K

AU - Volkers, Nicole A

AU - Donderwinkel, Peter F J

AU - de Blok, Sjoerd

AU - Birnie, Erwin

AU - Ankum, Willem M

AU - Reekers, Jim A

PY - 2005/11

Y1 - 2005/11

N2 - OBJECTIVE: This was a randomized controlled trial to evaluate the safety of uterine artery embolization (UAE) compared with hysterectomy.STUDY DESIGN: Twenty-eight Dutch hospitals recruited 177 patients with symptomatic uterine fibroids and menorrhagia who were eligible for hysterectomy. Patients were randomized to UAE (n = 88) or hysterectomy (n = 89). In this paper we evaluate the peri- and postprocedural complications, length of hospital stay, unscheduled visits, and readmission rates up to 6 weeks' post-intervention. Analysis was by intention to treat.RESULTS: Bilateral UAE failure occurred in 4 patients (4.9%). Major complications occurred in 4.9% (UAE) and 2.7% (hysterectomy) of cases (P = .68). The minor complication rate from discharge until 6 weeks after was significantly higher in the UAE group than in the hysterectomy group (58.0% vs 40.0%; RR 1.45 [1.04-2.02]; P = .024). UAE patients were more often readmitted (11.1% vs 0%; P = .003). Total length of hospital stay was significantly shorter in UAE patients (mean [SD]: 2.5 [2.7] vs 5.1 [1.3], P < .001).CONCLUSION: UAE is a procedure similar to hysterectomy with a low major complication rate and with a reduced length of hospital stay. Higher readmission rates after UAE stress the need for careful postprocedural follow-up.

AB - OBJECTIVE: This was a randomized controlled trial to evaluate the safety of uterine artery embolization (UAE) compared with hysterectomy.STUDY DESIGN: Twenty-eight Dutch hospitals recruited 177 patients with symptomatic uterine fibroids and menorrhagia who were eligible for hysterectomy. Patients were randomized to UAE (n = 88) or hysterectomy (n = 89). In this paper we evaluate the peri- and postprocedural complications, length of hospital stay, unscheduled visits, and readmission rates up to 6 weeks' post-intervention. Analysis was by intention to treat.RESULTS: Bilateral UAE failure occurred in 4 patients (4.9%). Major complications occurred in 4.9% (UAE) and 2.7% (hysterectomy) of cases (P = .68). The minor complication rate from discharge until 6 weeks after was significantly higher in the UAE group than in the hysterectomy group (58.0% vs 40.0%; RR 1.45 [1.04-2.02]; P = .024). UAE patients were more often readmitted (11.1% vs 0%; P = .003). Total length of hospital stay was significantly shorter in UAE patients (mean [SD]: 2.5 [2.7] vs 5.1 [1.3], P < .001).CONCLUSION: UAE is a procedure similar to hysterectomy with a low major complication rate and with a reduced length of hospital stay. Higher readmission rates after UAE stress the need for careful postprocedural follow-up.

KW - Adult

KW - Arteries

KW - Embolization, Therapeutic/adverse effects

KW - Female

KW - Follow-Up Studies

KW - Hospitalization

KW - Humans

KW - Hysterectomy/adverse effects

KW - Leiomyoma/surgery

KW - Middle Aged

KW - Postoperative Complications/epidemiology

KW - Uterine Neoplasms/surgery

KW - Uterus/blood supply

U2 - 10.1016/j.ajog.2005.05.017

DO - 10.1016/j.ajog.2005.05.017

M3 - Article

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SN - 0002-9378

VL - 193

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EP - 1629

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

IS - 5

ER -