April 2, 2016
French Multicenter Uterine Fibroid Embolization Study Shows Improvements in Sexual Desire and Function, Quality of Life
April 3, 2016—Data collected in a French multicenter study of women undergoing uterine fibroid embolization (UFE) indicate improved postprocedure quality of life, with specific progress observed in patient reporting of sexual desire and function. The SFICV EFUZEN study abstract was presented at the Society of Interventional Radiology’s 2016 Annual Scientific Meeting in Vancouver, British Columbia, by lead researcher Helene Vernhet-Kovacsik, MD, and colleagues. Dr. Vernhet-Kovacsik is an interventional radiologist at Centre Hospitalier Universitaire in Montpellier, France.
Data were prospectively collected at 25 French centers, with 264 patients participating. The patients were consecutively enrolled and asked to complete questionnaires regarding their UFE symptoms and health-related quality of life (UFE-QoL) at baseline and again at 1 year postprocedure. Additionally, they gave feedback regarding sexual desire and function via completion of Female Sexual Function Index (FSFI). Complete FSFI survey information was obtained in 170 patients, and 190 provided UFE-QoL feedback.
Before undergoing UFE, 189 of the patients reported abnormally heavy menstrual bleeding, and 171 said they experienced pain and other symptoms associated with pelvic pressure. At 1 year, these numbers had fallen to 39 and 42, respectively.
More than 90% of patients who completed the UFE-QoL assessment at 1 year described improvements in quality of life; the investigators reported average scores increasing from 45 to 71 during this period (on a scale of 0-100). Regarding sexual function, 78.8% of of patients who provided self-assessments at 1 year reported improvements including pain sensation, desire, arousal, and satisfaction. Correlation of fibroid and uterine volume reduction to patient-reported outcomes was not established.
Marc J. Sapoval, MD, PhD, one of the study’s investigators and a course director of the GEST embolization symposium, discussed the study with the media and described a large amount of global data supporting UFE. Randomized trials have shown that the procedure is as efficient and much less invasive than other options such as hysterectomy, with complications occurring very rarely, he said. Referral for UFE is growing in France, “But, we are still far from where we should be in terms of patients treated,” indicated the interventional radiologist at Hôpital Européen in Paris.
Citing a similar scenario in the United States, Robert L. Vogelzang, MD, from Northwestern University in Chicago, said that UFE has still not achieved the widespread success or use it should despite two decades of experience with the procedure. “We’re working to improve that, but, sadly, the patients who have fibroids are often not being told about embolization,” he said. “We’re doing about 10% of the fibroids here in America [via UFE] as best we can judge, but that still leaves hundreds of thousands of fibroids being treated by old means, which is unnecessary.”
Prof. Sapoval concluded that the data collected in this study add specific figures on quality of life and sexual function after UFE to the body of evidence supporting the procedure. Also providing commentary on the study, SIR President Alan H. Matsumoto, MD, of the University of Virginia, was hopeful that these data will help in the debate regarding the effectiveness of UFE in patients with symptomatic fibroids.