Title

Long term health related quality of life following Uterine Fibroid Embolization at Aga Khan University Hospital, Nairobi

Date of Award

2020

Document Type

Dissertation

Degree Name

Master of Medicine (MMed)

First Supervisor/Advisor

Professor Marleen Temmerman

Second Supervisor/Advisor

Dr. Adelaide Lusambili

Third Supervisor/Advisor

Dr. Timona Obura

Department

Obstetrics and Gynaecology (East Africa)

Abstract

Background: Uterine Fibroid Embolization (UFE) is one of the effective options available for treatment of symptomatic uterine fibroids with documented improvement in the quality of life and reduction in symptoms. Most of the studies have demonstrated an improvement in the quality of life over a short to intermediate period. We carried out this study to assess the long-term quality of life following uterine fibroid embolization in a predominantly black population. There are no identified studies locally or in Africa addressing this issue whereas studies done elsewhere indicate a probable increased fibroid disease burden among black women.

Objectives: Our objectives in this study were to determine the long-term health related quality of life, symptom severity and follow up procedures after UFE at Aga Khan University Hospital, Nairobi using the Uterine Fibroid Symptom and Quality of life (UFS-QOL) tool.

Methods: This was a retrospective single cohort study that recruited patients who had UFE between 2009-2014. Study participants were sampled consecutively, invited to the study and asked to fill an online general demographic tool and the UFS-QOL. A minimum calculated sample size of 60 was determined adequate to achieve the primary objective. The primary objective was to determine the health related quality of life outcome. The secondary objective was to assess symptom severity among the participants.

Results: Data was obtained from 77 participants. The median duration after the initial UFE was eight years. The median health related quality of life was 88.6 (62.9-98.3). This was statistically significant from baseline median scores of similar studies. The median symptom severity score decreased from a baseline score of 54.7 (43.8-65.6) to 21.9 (6.3-42.2). This decrease was statistically significant (p-value <0.001). Twenty-four participants (31.1%) reported follow up fibroid treatments after the initial UFE procedure. Eleven participants (14.3%) reported major repeat procedures (myomectomy, hysterectomy and UFE) .Seventeen participants (22%) reported a pregnancy after the UFE procedure with ten participants (13 %) reporting to have had children after the UFE procedure.

Conclusion: UFE results in clinically sustained improvement in health related quality of life and symptom control among patients with uterine fibroids.

This document is available in the relevant AKU library

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