Sexuality and body image after uterine artery embolization and hysterectomy in the treatment of uterine fibroids: a randomized comparison

Wouter J K Hehenkamp, Nicole A Volkers, Wouter Bartholomeus, Sjoerd de Blok, Erwin Birnie, Jim A Reekers, Willem M Ankum, Wouter J K Hehenkamp, Nicole A Volkers, Wouter Bartholomeus, Sjoerd de Blok, Erwin Birnie, Jim A Reekers, Willem M Ankum

Abstract

In this paper the effect of uterine artery embolization (UAE) on sexual functioning and body image is investigated in a randomized comparison to hysterectomy for symptomatic uterine fibroids. The EMbolization versus hysterectoMY (EMMY) trial is a randomized controlled study, conducted at 28 Dutch hospitals. Patients were allocated hysterectomy (n = 89) or UAE (n = 88). Two validated questionnaires (the Sexual Activity Questionnaire [SAQ] and the Body Image Scale [BIS]) were completed by all patients at baseline, 6 weeks, and 6, 12, 18, and 24 months after treatment. Repeated measurements on SAQ scores revealed no differences between the groups. There was a trend toward improved sexual function in both groups at 2 years, although this failed to reach statistical significance except for the dimensions discomfort and habit in the UAE arm. Overall quality of sexual life deteriorated in a minority of cases at all time points, with no significant differences between the groups (at 24 months: UAE, 29.3%, versus hysterectomy, 23.5%; p = 0.32). At 24 months the BIS score had improved in both groups compared to baseline, but the change was only significant in the UAE group (p = 0.009). In conclusion, at 24 months no differences in sexuality and body image were observed between the UAE and the hysterectomy group. On average, both after UAE and hysterectomy sexual functioning and body image scores improved, but significantly so only after UAE.

Trial registration: ClinicalTrials.gov NCT00100191.

Figures

Fig. 1
Fig. 1
Flowchart
Fig. 2
Fig. 2
Proportion of sexually active women, by treatment strategy, over time. (A) The weighted average of women who were not sexually active at baseline (B) and those who were sexually active at baseline (C)
Fig. 3
Fig. 3
Pleasure, discomfort, habit, and body image, by treatment strategy, over time

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