Obstetrics and Gynecology
doi: 10.25005/2074-0581-2020-22-3-362-372
ASSESSMENT OF THE UFS-QOL QUESTIONNAIRE BEFORE AND AFTER UTERINE ARTERY EMBOLIZATION FOR UTERINE LEIOMYOMA

A.K. Baratov1, F.R. Rakhimov2, E.L. Kalmykov3

1Department of Endovascular Surgery, Republican Scientific Center for Cardiovascular Surgery, Dushanbe, Republic of Tajikistan
2Department of Surgical Diseases № 2, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
3Vascular and Endovascular Surgery Clinic, Helios University Hospital, Wuppertal, Germany

Objective: To assess of the quality of life before and after uterine artery embolization (UAE) for uterine leiomyoma.

Methods: A survey of 15 women aged 23 to 47 years was conducted using the UFS-QOL questionnaire. The number of fibroids varied from 1 to 6. Fibroids were mainly localized: submucosal (53.3%), intramural (20%), and subserosal (26.7%). Their volume varied in the range of 25.04-294.09 ml. The dominant syndrome in 7 cases was hemorrhagic, in 7 – compression, and in 1 case – their combination. All women underwent UAE. The survey was conducted four times: before, 3, 6 and 12 months after UAE.

Results: According to symptom severity subscale of the UFS-QOL questionnaire (8 questions), there was a significant improvement in symptoms 12 months after UAE in comparison with the baseline: a decrease of mean score from 43.3 to 14.0 (p<0.001). Analysis of the health related quality of life (HRQL) subscale (29 questions) also showed a significant improvement in the quality of life after 12 months compared to the initial level: an increase of mean score from 54.3 to 82.8 (p<0.001). The most significant dynamics (p<0.001) was noted for such domains «Concern», «Activities», «Energy/mood», and «Control» (p<0.001). The mean scores for the above domains increased from the baseline values 53.3±16.0; 56.4±18.4; 42.9±18.0 and 53.7±20.1 to 86.0±11.2; 86.9±11.6; 75.2±10.0 and 81.3±11.2 points after 12 months, respectively. For 2 other subsections of the HRQL «Self-consciousness» and «Sexual function», the mean score changes slightly differed: 67.2±32.2 and 71.7±32.9 (initially) and 85.0±12.3 and 86.7±22.4 (after 12 months) (p<0.05 and p<0.01, respectively). The total HRQL mean score also significantly (p<0.001) increased by month 12 from the baseline of 54.3±14.7 to 82.8±7.4.

Conclusion: The UFS-QOL questionnaire is a very informative tool for assessing both the severity of the symptoms of uterine fibroids and the quality of life of women who underwent uterine artery embolization. According to the results of the UFS-QOL, a significant dynamics was obtained with respect to both the regression of symptoms of uterine fibroids, and the improvement of all parameters of the quality of life.

Keywords: Uterine leiomyoma, uterine artery embolization, quality of life, UFS-QOL questionnaire.

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References
  1. Stewart EA, Cookson CL, Gandolfo RA, Schulze-Rath R. Epidemiology of uterine fibroids: a systematic review. BJOG. 2017;124:1501-12.
  2. Okolo S. Incidence, aetiology and epidemiology of uterine fibroids. Best Pract Res Clin Obstet Gynaecol. 2008;22:571-88.
  3. Babadjanova GS, Tukhtamisheva NO. Sovremennyy vzglyad na diagnostiku i lechenie miomy matki u zhenshchin reproduktivnogo vozrasta [Modern view on diagnosis and treatment of uterine fibroids in women reproductive age]. Biologiya i integrativnaya meditsina. 2017;2:64-79.
  4. Babadjanova GS, Mirzaeva DB, Gulomova MA. Otsenka vedeniya beremennosti i rodov u zhenshchin s miomoy matki [Assessment of pregnancy and delivery management in women with uterine leiomyoma]. Biologiya i integrativnaya meditsina. 2017;2:111-7.
  5. Feofilova MA, Pavlov OG, Geymerling VE. Vliyanie obraza zhizni i proizvodstvennykh vrednostey na razvitie miomy matki [The effect of life-style and occupational hazards on development of uterine leiomyoma]. Problemy sotsial’noy gigieny, zdravookhraneniya i istorii meditsiny. 2018;26(6):406-10. Available from: https://doi.org/10.32687/0869-866X-2018-26-6-406-410
  6. Coyne KS, Harrington A, Currie BM, Chen J, Gillard P, Spies JB. Psychometric validation of the 1-month recall Uterine Fibroid Symptom and Health-Related Quality of Life questionnaire (UFS-QOL). J Patient Rep Outcomes. 2019;3:57. Available from: https://doi.org/10.1186/s41687-019-0146-x
  7. Laughlin-Tommaso SK, Lu D, Thomas L, Nicholson WK, Stewart EA, Myers ER, et al. Short-term quality of life after myomectomy for uterine fibroids from the COMPARE-UF Fibroid Registry. Am J Obstet Gynecol. 2020;222:345.e1-22.
  8. Ming WK, Wu H, Wu Y, Chen H, Meng T, Shen Y, et al. Health-related quality of life in pregnancy with uterine fibroid: a cross-sectional study in China. Health and Quality of Life Outcomes. 2019;17:89. Available from: https:// doi.org/10.1186/s12955-019-1153-6
  9. Coyne KS, Margolis MK, Murphy J, Spies J. Validation of the UFS-QOL-hysterectomy questionnaire: modifying an existing measure for comparative effectiveness research. Value in Health. 2012;15:674-9.
  10. da Silva RO, Gomes MTV, Castro RA, Bonduki CE, Girao MJBC. Uterine fibroid symptom – quality of life questionnaire translation and validation into Brazilian Portuguese. Rev Bras Ginecol Obstet. 2016;38:518-23.
  11. Mariara C, Obura T, Hacking N, Stones W. One year symptom severity and health-related quality of life changes among Black African patients undergoing uterine fibroid embolisation. BMC Res Notes. 2017;10:240. Available from: https://doi.org/10.1186/s13104-017-2558-0
  12. Herve F, Katty A, Isabelle Q, Celine S. Impact of uterine fibroids on quality of life: a national cross-sectional survey. European Journal of Obstetrics, Gynecology and Reproductive Biology. 2018;229:32-7. Available from: https:// doi.org/10.1016/j.ejogrb.2018.07.032
  13. Fennessy FM, Kong CY, Tempany CM, Swan JS. Quality-of-life assessment of fibroid treatment options and outcomes. Radiology. 2011;259(3):785-792. Available from: https://doi.org/10.1148/radiol.11100704
  14. Harding G, Coyne KS, Thompson CL, Spies JB. The responsiveness of the uterine fibroid symptom and health-related quality of life questionnaire (UFSQOL). Health Qual Life Outcomes. 2008;6(1):99. Available from: https://doi. org/10.1186/1477-7525-6-99
  15. Yeung SY, Kwok JWK, Law SM, Chung JPW, Chan SSC. Uterine Fibroid Symptom and Health-related Quality of Life Questionnaire: a Chinese translation and validation study. Hong Kong Med J. 2019;25:453-9. Available from: https://doi.org/10.12809/hkmj198064
  16. de Bruijn AM, Ankum WM, Reekers JA, Birnie E, van der Kooij SM, Volkers NA, et al. Uterine artery embolization vs hysterectomy in the treatment of symptomatic uterine fibroids: 10-year outcomes from the randomized EMMY trial. Am J Obstet Gynecol. 2016;215(6):745.e1-745.e12. Available from: Available from: https://doi.org/10.1016/j.ajog.2016.06.051
  17. Laughlin-Tommaso SK, Weaver AL, Vaughan LE, Jacoby V, Stewart EA. Long term outcomes in a randomized controlled trial of uterine artery embolization and MR-guided focused ultrasound: the FIRSTT Study. Fertility and Sterility. 2017;108(3):e26. Available from: https://doi.org/10.1016/j.fertnstert. 2017.07.09
  18. Fonseca MCM, Castro R, Machado M, Conte T, Girao MJBC. Uterine artery embolization and surgical methods for the treatment of symptomatic uterine leiomyomas: a systemic review and meta-analysis followed by indirect treatment comparison. Clin Ther. 2017;39(7):1438-55.e2. Available from: https:// doi.org/10.1016/j.clinthera.2017.05.346
  19. Karlsen K, Hrobjartsson A, Korsholm M, Mogensen O, Humaidan P, Ravn P. Fertility after uterine artery embolization of fibroids: a systematic review. Arch Gynecol Obstet. 2018;297(1):13-25. Available from: https://doi. org/10.1007/s00404-017-4566-7
  20. Kalmykov EL, Rakhimov FR, Umarzoda SG, Baratov AK. Embolizatsiya matochnykh arteriy pri leyomiome matki: sostoyanie problemy [Uterine artery embolization for leiomyoma: the state of the problem]. Akusherstvo i ginekologiya. 2020;9:18-26.
  21. Duvnjak S, Ravn P, Green A, Andersen PE. Assessment of uterine fibroid infarction after embolization with tris-acryl gelatin microspheres. Cogent Medicine. 2017;4(1):1360543. Available from: https://doi.org/10.1080/233120 5X.2017.1360543
  22. Yadavali R, Ananthakrishnan G, Sim M, Monaghan K, McNaught G, Hamoodi I, et al. Randomised trial of two embolic agents for uterine artery embolisation for fibroids: Gelfoam versus Embospheres (RAGE trial). CVIR Endovascular. 2019;2:4. Available from: https://doi.org/10.1186/s42155-018-0044-y
  23. Fasciani A, Turtulici G, Siri G, Ferrero S, Sirito R. A prospective intervention trial on tailored radiofrequency ablation of uterine myomas. Medicina. 2020;56:122. doi: 10.3390/medicina56030122
  24. Manyonda I, Belli AM, Lumsden MA, Moss J, McKinnon W, Middleton LJ, et al. Uterine-artery embolization or myomectomy for uterine fibroids. NEJM. 2020;383:440-51. Available from: https://doi.org/10.1056/NEJMoa1914735
  25. Spies JB, Coyne K, Guaou Guaou N, Boyle D, Skyrnarz-Murphy K, Gonzalves SM. The UFS-QOL, a new disease-specific symptom and health-related quality of life questionnaire for leiomyomata. Obstet Gynecol. 2002;99:290-300.
  26. Spies JB, Coyne K, Guaou Guaou N, Boyle D, Skyrnarz-Murphy K, Gonzalves SM. The UFS-QOL, a new disease-specific symptom and health-related quality of life questionnaire for leiomyomata. Obstet Gynecol. 2002;99:290-300.

Authors' information:

Baratov Alisher Kenjaevich
Candidate of Medical Sciences, Associate Professor, Endovascular Surgeon, Department of Endovascular Surgery, Republican Scientific Center for Cardiovascular Surgery
Researcher ID: AAE-6818-2019
Scopus ID: 8249648700
ORCID ID: 0000-0002-8072-5751
SPIN: 6576-1680
Author ID: 268956
E-mail: alishbar@rambler.ru

Rakhimov Farshed Rustamovich
Postgraduate Student, Department of Surgical Diseases № 2, Avicenna Tajik State Medical University
ORCID ID: 0000-0001-7418-1383
E-mail: frrahimov@mail.ru

Kalmykov Egan Leonidovich
Candidate of Medical Sciences, Vascular Surgeon, Vascular and Endovascular Surgery Clinic, Helios University Hospital
Researcher ID: K-9827-2013
Scopus ID: 36172240400
ORCID ID: 0000-0001-6784-2243
SPIN: 8623-8897
Author ID: 843609
E-mail: egan0428@mail.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Baratov Alisher Kenjaevich
Candidate of Medical Sciences, Associate Professor, Endovascular Surgeon, Department of Endovascular Surgery, Republican Scientific Center for Cardiovascular Surgery

734003, Republic of Tajikistan, Dushanbe, Sanoi str., 33

Tel.: +992 (907) 978815

E-mail: alishbar@rambler.ru


This work is licensed under a Creative Commons Attribution 4.0 International License.

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