CHICAGO – Uterine artery embolization for the treatment of fibroids also appears to improve lower urinary tract symptoms, a small study has shown.
Women who underwent uterine artery embolization (UAE) for fibroids had an average improvement of 23 points on the Urinary Distress Inventory (UDI-6).
"We had a significant improvement in all of the measures, except for the number of accidents," said Dr. James B. Spies, professor and chairman of radiology at Georgetown University, Washington.
The researchers recruited 46 women (average age, 44 years), who were undergoing UAE at the George Washington University Medical Center between 2008 and 2010. Each patient completed a set of validated questionnaires assessing urinary symptoms and quality of life impact, and fibroid symptoms and quality of life impact, as well as a 48-hour urinary diary before and after UAE. The women also completed these questionnaires and a urinary diary at 3 months post procedure.
Lower urinary tract symptoms included an increased frequency of urination, a sudden urgent need to urinate, difficulty urinating (retention), and incontinence.
The researchers used several validated tools to assess improvement in urinary symptoms, including the UDI-6, the Incontinence Impact Questionnaire (IIQ-7), the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), the Uterine Fibroid Symptom and Quality of Life Questionnaire (UFS-QoL), and a standardized 48-hour bladder diary.
The Patient Global Impression of Improvement (PGI-I) also was used to assess patient satisfaction with the procedure. The primary outcome was the measure of subjective improvement in lower urinary tract symptoms at 3 months, as measured by the UDI-6.
In addition to improvement on the UDI-6, there was a mean reduction of 15 points on the IIQ-7. There were also significant decreases in the mean scores for the PISQ-12 and UFS-QoL, Dr. Spies said at the annual meeting of the Society of Interventional Radiology.
Using regression modeling, the researchers found that uterine volume, dominant fibroid volume, location of the fibroid, and bladder compression did not affect the scores, but obesity did. For each unit increase in body mass index, the improvement in the UDI-6 scores was decreased by 1.8.
Dr. Spies and his associates reported they had no relevant financial disclosures.