Treatment for fibroids: Uterine Artery Embolisation (UAE) or hysterectomy (HOPEFUL) - Primary Research (e.g. trial)

Hirst A, Dutton S, Wu O, Briggs A, Edwards C, Waldenmaier L, Maresh M, Nicholson A, McPherson K
Record ID 32005001015
Authors' objectives:

To examine and compare the mediumterm results of hysterectomy and uterine artery embolisation (UAE) as a treatment for symptomatic uterine fibroids with regard to safety, efficacy, special issues in the UAE group, cost-effectiveness, and women’s own perspectives on the treatments.

Authors' recommendations: The study results suggest that both UAE and hysterectomy are safe. No unexpected problems were detected following UAE after a long follow-up period (average 5 years). Complications are less common for UAE than hysterectomy. The cost effectiveness analysis favours embolisation even after taking account of complications, expected side-effectsassociated with the procedure and subsequent re-treatments for women with a preference for uterus preservation. It is important to improve the management of expectations following UAE, particularly regarding fertility. The data suggested that fertility and miscarriage rate are consistent with those of age-matched women with fibroids. UAE is aneffective treatment for some women with fibroids and our trial supports the National Institute for Health and Clinical Excellence guidance that it should be made available as one of the options for treatment, with a possible reduction in the need for hysterectomy as the first-line treatment. Further research is needed into which women will be treated most successfully by UAE, the best method of achieving effective embolisation, advice for women who desire future fertility, the role of prophylactic antibiotics in UAE, andthe effects of HRT use after UAE on recurrence of fibroid symptoms.
Project Status: Completed
URL for project:
Year Published: 2008
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Decision Making
  • Female
  • Hysterectomy
  • Treatment Outcome
  • Uterine Artery Embolization
  • Cost-Benefit Analysis
  • Leiomyoma
  • Embolization, Therapeutic
  • Endometrium
  • Myometrium
  • Uterine Diseases
  • Uterus
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
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Copyright: 2009 Queen's Printer and Controller of HMSO
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