WASHINGTON — Uterine artery embolization resulted in similar short-term morbidity but greater long-term morbidity, compared with total laparoscopic hysterectomy, Lindsay Mains, M.D., and colleagues reported during the annual meeting of District VII of the American College of Obstetricians and Gynecologists.
The researchers conducted a nonrandomized, retrospective study at their institution, the Ochsner Clinic Foundation in New Orleans. and presented their findings in poster form at the meeting.
Over a 4-year-period, they compared the cases of 103 patients who chose uterine artery embolization (UAE) with 175 patients who elected to have total laparoscopic hysterectomy (TLH).
In addition to reviewing medical records, the researchers conducted telephone interviews to compare preoperative data, complication rates, readmission rates, length and severity of recovery, and need for more treatment.
Both groups in the study had comparable demographics and baseline characteristics.
There were no statistically significant differences reported between the UAE and TLH groups in intraoperative complication rates (2.8% vs. 2.9%), postoperative complication rates (5.7% vs. 3.9%), or readmission rates (6.9% vs. 2.9%). Both groups experienced similar lengths of recovery and postoperative pain, Dr. Mains, an ob.gyn. at the clinic, said in an interview.
However, UAE patients were significantly more likely to need further surgery, compared with the TLH patients (15.5% vs. 4.6%). The UAE patients expressed greater dissatisfaction with their choice than did members of the TLH (38.5% vs. 7.7%), saying they would opt for a different treatment if they had to do it over.
“When intraoperative complications, postoperative complications, need for readmission, need for further treatment, and failure to treat symptoms were combined to be described as 'clinical failures,' UAE resulted in significantly more clinical failures than did TLH,” the researchers concluded.