EMMY trial: a randomised comparison of uterine artery embolisation and hysterectomy for the treatment of symptomatic uterine fibroids

Uterine artery embolisation (UAE) is a new treatment for heavy menstrual bleeding caused by uterine fibroids. The EMMY trial evaluates the safety and efficacy of UAE in a randomised comparison to hysterectomy. Patients were included when they had uterine fibroids and menorrhagia and were eligible for hysterectomy. The primary endpoint is the elimination of menorrhagia after a 1-year follow-up period. Secondary endpoints comprise: effect on complaints of pain and pressure, quality of life issues, uterine volume reduction, effect on ovarian function and cost-effectiveness. 177 Patients were randomly assigned (1:1) to either UAE (n=88) or hysterectomy (n=89). The results of this trial will be presented at a later stage. UAE is already being performed on a regular basis, without profound evidence: no good quality randomised controlled trials have been conducted. This trial is the first to evaluate the value of UAE in clinical practice with a control group. Whether UAE can replace hysterectomy as treatment of first choice depends on the balance of efficacy, costs and quality of life.