A Comparative Analysis of Health-Related Quality of Life 1 Year Following Myomectomy or Uterine Artery Embolization: Findings from the COMPARE-UF Registry

Raymond M. Anchan, Daniel Wojdyla, Pietro Bortoletto, Kathryn Terry, Emily Disler, Ankrish Milne, Antonio Gargiulo, John Petrozza, Olga Brook, Serene Srouji, Cynthia C. Morton, James Greenberg, Ganesa Wegienka, Elizabeth A. Stewart, Wanda K. Nicholson, Laine Thomas, Sateria Venable, Shannon Laughlin-Tommaso, Michael P. Diamond, G. Larry MaxwellErica E. Marsh, Evan R. Myers, Anissa I. Vines, Lauren A. Wise, Kedra Wallace, Vanessa L. Jacoby, James B. Spies

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To compare 12-month post-treatment health-related quality of life (HR-QoL) and symptom severity (SS) changes among patients with symptomatic uterine fibroids (SUF) not seeking fertility and undergo a hysterectomy, abdominal myomectomy (AM), or uterine artery embolization (UAE). Materials and Methods: The Comparing Options for Management: Patient-Centered Results for Uterine Fibroids (COMPARE-UF) Registry is a multi-institutional prospective observational cohort study of patients treated for SUF. A subset of 1465 women 31-45 years of age, who underwent either hysterectomy (n = 741), AM (n = 446), or UAE (n = 155) were included in this analysis. Demographics, fibroid history, and symptoms were obtained by baseline questionnaires and at 1 year post-treatment. Results were stratified by all treatments and propensity score weighting to adjust for differences in baseline characteristics. Results: Women undergoing UAE reported the lowest baseline HR-QoL and highest SS scores (mean = 40.6 [standard deviation (SD) = 23.8]; 62.3 [SD = 24.2]) followed by hysterectomy (44.3 [24.3]; 59.8 [SD = 24.1]). At 12 months, women who underwent a hysterectomy experienced the largest change in both HR-QoL (48.7 [26.2]) and SS (51.9 [25.6]) followed by other uterine-sparing treatments. Propensity score weighting revealed all treatments produced substantial improvement, with hysterectomy patients reporting the highest HR-QoL score (92.0 [17.8]) compared with myomectomy (86.7 [17.2]) and UAE (82.6 [21.5]) (p < 0.0001). Similarly, hysterectomy patients reported the lowest SS scores (8.2 [15.1]) compared with myomectomy (16.5 [15.1]) and UAE (19.6 [17.5]) (p < 0.0001). Conclusion: All procedures showed improvement in HR-QoL and reduction in SS score at 12 months, hysterectomy showing maximum improvement. Of importance, at 12 months, patients who underwent either a myomectomy or UAE reported comparable symptom relief and HR-QoL.

Original languageEnglish
Pages (from-to)423-433
Number of pages11
JournalJournal of Women's Health
Volume32
Issue number4
Early online date13 Jan 2023
DOIs
Publication statusPublished - 1 Apr 2023

Keywords

  • hysterectomy
  • myomectomy
  • quality of life
  • uterine artery embolization
  • uterine fibroids

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