Objective: To evaluate the effectiveness and safety of uterine arterial embolization (UAE) in the management of symptomatic uterine myomas compared with myomectomy.
Methods: All clinical trials on UAE treating symptomatic uterine myomas indexed in PubMed and Chinese National Knowledge Infrastructure (CNKI) were reviewed using meta-analysis by Revman 4.1 software. The patients were classified into two groups, i.e., UAE trial group and control group. Intervention method in control group was surgery of uterine myomectomy. There were no differences between two groups in age, general physical status, and manifestation of uterine myoma.
Results: Six hundred and eighty patients with symptomatic uterine myoma in eight trials were included into this study according to selection criteria of Cochrane collaboration. Meta-analysis indicated that weight of every trial contributing to the study was related to its number of patients in direct ratio, but not related to quality scale of the trial. There were no statistical differences between these trials in evaluation criteria (P > 0.05). Relative risk (RR) between UAE patients and control group was 0.95, and 95% CI was 0.92 - 0.99. The success rate (92.3%) of UAE group was 95% of control group (96.7%), with a significant difference between them (P < 0.05).
Conclusions: Surgical procedures to treat uterine myomas have more effective outcomes than UAE. Patients who select UAE procedure may have 95% opportunity to improve clinical symptoms and avoid some surgical risks, and also have a higher life quality in future, although this has to be testified by long term follow-up.
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