Evaluation of the Efficacy and Complications of Uterine Artery Embolization in Comparison with Laparotomy-Myomectomy in the Treatment of Uterine Myomas: A Randomized Clinical Trial.

ABSTRACT

Background: Due to the high prevalence of uterine fibroids or leiomyomas in women of reproductive age and the many treatment options for myomas, finding the best treatment is a challenge for surgeons. Therefore, this study aimed at evaluating the efficacy and safety of 2 treatment options surgical interventions and uterine artery embolization (UAE) in patients with uterine myoma. Methods: The present study was a single-blind randomized clinical trial. The study population included all women with uterine myoma. Hence, 80 patients were divided into 2 groups of 40. The first group underwent laparotomy-myomectomy and the second underwent UAE. These patients were evaluated for clinical symptoms, menstrual disorders, estimated blood loss per menstrual cycle, and pain and complication on the 10th day, and at 2, 6, and 12 months after the intervention. The data were analyzed with SPSS software (Version 25) using an independent samples t test, a repeated measure analysis, and a chi-square test. Results: Ten days, 2, 6, and 12 months after the intervention, there was no significant difference between the 2 approaches in terms of their decreasing effects on per menstrual cycle blood loss (p > 0.05), respectively. After 10 days and 2 months, the pain intensity in the embolization group was higher than laparotomy group (p = 0.045, 0.060), respectively. The pain intensity was also not significantly different between the 2 groups after 6 months and 1 year (p > 0.05), respectively. Also, the frequency of fever was higher in the embolization group (p = 0.745). However, the documented post-procedural complications indicated that hemoglobin level declined post-operation (p > 0.050). Conclusion: The results showed no significant difference between the 2 groups in terms of post-procedural mensuration blood loss or pain intensity and the incidence of menstrual disorders within 1 year. It seems that there is no significant difference between the 2 groups and it may be possible to use the UAE depending on the patient's condition.