In the FEMME trial comparing uterine artery embolization (UAE) with myomectomy for symptomatic fibroids in women wishing to preserve uterus, the primary outcome at 4 years showed:
- A UAE was superior with better quality of life scores
- B Myomectomy was superior with lower reintervention rates and better QoL
- C Similar quality of life scores but UAE had higher reintervention rates ✓
- D Similar QoL but myomectomy had higher surgical complication rates
Explanation
The FEMME trial (2020), a UK randomized trial comparing UAE vs. myomectomy, showed similar quality-of-life scores (UFS-QoL) at 4 years between the two treatments. However, UAE was associated with significantly higher reintervention rates (40% UAE vs. 13% myomectomy at 4 years), largely due to fibroid regrowth and persistent symptoms. Myomectomy provides more durable symptom relief but with higher intraoperative risks, longer recovery, and risk of uterine rupture in subsequent pregnancy. The similar QoL outcomes support offering both options, but women should be counseled about higher reintervention rates with UAE. This adds to prior EMMY and REST trial data supporting UAE as a safe alternative to surgery for symptom control.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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Written and medically reviewed by the StethoPrep medical team.