Medico-economic approach to the management of uterine myomas: a 6-month cost-effectiveness study of pelvic embolization versus vaginal hysterectomy

Eur J Obstet Gynecol Reprod Biol. 2003 Nov 10;111(1):59-64. doi: 10.1016/s0301-2115(03)00188-x.

Abstract

Introduction: Uterine artery embolization is a technique that has been recently proposed for the management of uterine myomas an alternative to vaginal hysterectomy. The results provided by the first published studies demonstrate a significant decrease in symptoms in 70-95% of cases. The aim of our study was to compare the cost-effectiveness ratios for pelvic embolization and vaginal hysterectomy looked at from the hospital point of view.

Materials and methods: Two populations of patients were randomly selected from women undergoing pelvic embolization or vaginal hysterectomy. We retrospectively measured the cost at 6 months of the two types of procedure (costs of hospitalization, drugs, and complementary examinations) as well as the success of each of them at 6 months. The cost of the techniques themselves were measured prospectively on the basis of four procedures.

Results: The cost-effectiveness ratios were 2320 Euros per success (mean cost 2134 Euros per effectiveness 92%) for embolization and 2789 Euros per success (mean cost 2789 Euros per effectiveness 100%) for hysterectomy.

Discussion: Pelvic embolization is more cost-effective than vaginal hysterectomy. The integration of the notion of quality of life with the notion of cost should permit a future study to reinforce interest in performing pelvic embolizations in the management of uterine myomas.

Publication types

  • Comparative Study

MeSH terms

  • Cost-Benefit Analysis
  • Embolization, Therapeutic / economics*
  • Female
  • Humans
  • Hysterectomy, Vaginal / economics*
  • Middle Aged
  • Myoma / surgery
  • Myoma / therapy*
  • Pelvis
  • Retrospective Studies
  • Uterine Neoplasms / surgery
  • Uterine Neoplasms / therapy*