Long-term follow up of uterine artery embolisation--an effective alternative in the treatment of fibroids.

OBJECTIVES To evaluate the long-term efficacy and complications of uterine artery embolisation (UAE) for treatment of symptomatic uterine fibroids. DESIGN A prospective observational study. SETTING A district general hospital and two private hospitals in the southeast of England. POPULATION Women with symptomatic fibroids who had been offered surgical options for treatment. METHODS Postal questionnaire follow up at 5-7 years to assess long-term clinical effects among women who had undergone UAE. MAIN OUTCOME MEASURES The questionnaire was subdivided into sections dealing with menstrual flow, amenorrhoea and menopause, fibroid-related symptoms, fertility, vaginal discharge, sexual function, subsequent treatments for fibroids and satisfaction with the procedure. RESULTS A total of 258 women were identified as being between 5 and 7 years post-UAE and suitable for long-term follow up in October 2004. One hundred seventy-two completed questionnaires were analysed (67% response rate). Seventy-five percent of women still had either a return to normal or an improvement in menstrual flow compared with how they were prior to UAE. More than 80% of fibroid-related symptoms were still resolved or improved. Sixteen percent of women required further treatment for fibroids. Premature menopause directly following UAE occurred in only one woman in the study group. Eighty-eight percent of women were satisfied with the outcome of the procedure at 5-7 years and would choose it again or recommend it to others. CONCLUSIONS These findings show that UAE is of benefit to women wishing to avoid hysterectomy and it carries a low risk of complications.