***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE To prospect ively evaluate health-related quality of life ( HRQOL ) outcomes for  uterine artery embolization ( UAE ) and hysterectomy  up to 24 months after the intervention in terms of mental and physical health , urinary and defecatory function , and overall patient satisfaction . MATERIAL S AND METHODS Ethics committee approval and informed consent were obtained for the Embolisation versus Hysterectomy Trial . Women ( n = 177 ) with uterine fibroids and heavy menstrual bleeding who were scheduled to undergo hysterectomy were r and omly assigned to undergo UAE ( n = 88 ) or hysterectomy ( n = 89 ) .  HRQOL was measured six times during a 24-month follow-up period with the following vali date d question naires : Medical Outcome Study Short Form 36 ( SF-36 ) mental component summary ( MCS ) and physical component summary ( PCS ) , Health Utilities Index Mark 3 , EuroQol 5D , urogenital distress inventory ( UDI ) , incontinence impact question naire , and defecation distress inventory ( DDI ) . Satisfaction was assessed with a seven-point Likert scale . Repeated measurement analysis was performed for between-group analysis . Paired t tests were performed for within-group analysis . Satisfaction was analyzed with the Fisher exact test . RESULTS The SF-36 MCS and PCS , Health Utilities Index Mark 3 , EuroQol 5D , and UDI scores were improved significantly in both groups at 6 months and afterward ( P < .05 ) . The DDI score was improved significantly in only the UAE group at 6 months and afterward ( P < .05 ) . No differences between groups were observed , with the exception of PCS scores at 6-week follow-up : Patients in the UAE group had significantly better scores than did patients in the hysterectomy group ( P < .001 ) . Improvement in PCS score at 24-month follow-up was significantly higher for patients who were employed at baseline ( P = .035 ) . At 24-month follow-up , patients in the hysterectomy group were significantly more satisfied than those in the UAE group ( P = .02 ) . CONCLUSION Both UAE and hysterectomy improved HRQOL . No differences were observed between groups regarding HRQOL at 24-month follow-up . On the basis of HRQOL results , the authors determined that UAE is a good alternative to hysterectomy OBJECTIVE The purpose of this study was to evaluate the long-term outcomes of uterine artery embolization using only gelatin sponge particles for symptomatic fibroids . MATERIAL S AND METHODS As part of an ongoing study of the procedure for fibroids , prospect i ve data of the initial 96 consecutive women treated between December 1997 and December 2001 , were collected in January 2005 . It had been more than 3 years since embolization in all cases . The follow-up period ranged from 4 to 60 months ( mean , 37.4 months ) . On the basis of serial question naires , we investigated the cumulative rates of symptom control , gynecologic interventions , and overall failure , using the Kaplan-Meier product limit estimator . Symptom control was defined as meaning patients whose symptoms had improved as indicated on the last question naire and who had not undergone any further gynecologic intervention because of symptoms . Overall failure was defined as meaning the patients who indicated that there had been no symptom improvement or recurrence or that they had undergone further gynecologic interventions . RESULTS Of all 96 women , 16 ( 17 % ) were lost to follow-up during the period . Cumulative rates of symptom control were 96.9 % at 1 year , 89.5 % at 3 years , and 89.5 % at 5 years . Cumulative rates of complications related to the gynecologic intervention and overall gynecologic interventions were 2.1 % and 4.2 % , respectively , at 1 year , 2.1 % and 5.4 % at 3 years , and 2.1 % and 10.5 % at 5 years . Cumulative rates of overall failure were 4.2 % at 1 year , 12.7 % at 3 years , and 12.7 % at 5 years . Major complications were noted in 3.1 % ( 3/96 ) . Of these three women , two required hospitalization for transvaginal resection of sloughing fibroids and one developed sexual dysfunction . Two women became pregnant , but both pregnancies result ed in miscarriage . CONCLUSION Uterine artery embolization using gelatin sponge particles alone can achieve long-term symptom control for fibroids in most cases AIM The purpose of this study was to compare the depth of vascular penetration of non-spherical polyvinyl alcohol ( PVA ) versus trisacryl gelatin microspheres ( MS ) in women undergoing uterine artery embolization ( UAE ) immediately before transabdominal myomectomy . MATERIAL S AND METHODS A total of 17 patients who had been referred for embolization before myomectomy underwent bilateral uterine artery embolization using either 355 - 500 microm PVA ( group A ) or 700 - 900 microm MS ( group B ) . The depth of penetration of the particles was assessed by identifying their presence and location in the resected specimen . RESULTS Of the 17 women enrolled in this study , 10 were in group A and 6 in group B. One woman underwent embolization using both types of particle and was excluded from the analysis . Embolic particles were significantly ( p = 0.048 ) more frequently located within the fibroid ( 4/6 , 67 % ) in Group B than Group A ( 1/10 , 10 % ) . Particles were also identified in the perifibroid tissues in 4/6 ( 67 % ) in Group B and 4/10 ( 40 % ) in Group A , with no statistical difference . There were no procedural complications . CONCLUSION MS particles ( 700 - 900 microm ) penetrate significantly deeper into leiomyomata compared with non-spherical PVA ( 355 - 500 microm ) . MS may therefore confer advantages in UAE , as they may more specifically target the fibroid , allowing an earlier end-point to embolization and minimizing ischaemic damage to normal myometrium and ovaries BACKGROUND The efficacy and safety of uterine-artery embolization , as compared with st and ard surgical methods , for the treatment of symptomatic uterine fibroids remain uncertain . METHODS We conducted a r and omized trial comparing uterine-artery embolization and surgery in women with symptomatic uterine fibroids . The primary outcome was quality of life at 1 year of follow-up , as measured by the Medical Outcomes Study 36-Item Short-Form General Health Survey ( SF-36 ) . RESULTS Patients were r and omly assigned in a 2:1 ratio to undergo either uterine-artery embolization or surgery , with 106 patients undergoing embolization and 51 undergoing surgery ( 43 hysterectomies and 8 myomectomies ) . There were no significant differences between groups in any of the eight components of the SF-36 scores at 1 year . The embolization group had a shorter median duration of hospitalization than the surgical group ( 1 day vs. 5 days , P<0.001 ) and a shorter time before returning to work ( P<0.001 ) . At 1 year , symptom scores were better in the surgical group ( P=0.03 ) . During the first year of follow-up , there were 13 major adverse events in the embolization group ( 12 % ) and 10 in the surgical group ( 20 % ) ( P=0.22 ) , mostly related to the intervention . Ten patients in the embolization group ( 9 % ) required repeated embolization or hysterectomy for inadequate symptom control . After the first year of follow-up , 14 women in the embolization group ( 13 % ) required hospitalization , 3 of them for major adverse events and 11 for reintervention for treatment failure . CONCLUSIONS In women with symptomatic fibroids , the faster recovery after embolization must be weighed against the need for further treatment in a minority of patients . ( IS RCT N.org number , IS RCT N23023665 [ controlled-trials.com ] . PURPOSE To compare tris-acryl microspheres and polyvinyl alcohol ( PVA ) microspheres as embolic agents in uterine artery embolization ( UAE ) for uterine leiomyomas in terms of clinical outcome , inflammatory response , and adverse reactions . MATERIAL S AND METHODS A double-blinded r and omized controlled trial was performed , with 27 patients in the tris-acryl microsphere group and 29 in the PVA microsphere group .  The primary endpoint was clinical success , defined as a 2-year freedom from subsequent surgery as a result of persistent or deteriorated symptoms . Secondary endpoints included ( i ) posttreatment leiomyoma enlargement , ( ii ) leiomyoma volume reduction at 3 and 9 months , ( iii ) significant residual intratumoral perfusion , ( iv ) increase in inflammatory and stress markers , ( v ) incidence of complications , and ( vi ) duration of hospital stay . RESULTS There was no statistically significant difference between the two groups in patient demographics , clinical presentation , initial tumor findings , change in inflammatory and stress markers after treatment , incidence of complications , and duration of hospital stay .  Tris-acryl microspheres were associated with a higher rate of clinical success than PVA microspheres ( 96.3 % [ 26 of 27 ] vs 69 % [ 20 of 29 ] ; P = .012 ) , a lower incidence of posttreatment leiomyoma enlargement ( P = .030 ) , and a lower incidence of significant residual intratumoral perfusion ( P = .030 ) . CONCLUSIONS In the treatment of uterine leiomyomas , UAE with tris-acryl microspheres was associated with a higher clinical success rate , a lower incidence of tumor enlargement , and no significant differences in adverse reactions and inflammatory response compared with the use of PVA microspheres . Tris-acryl microspheres therefore represent the preferred agent for UAE of uterine leiomyomas Objective To evaluate the efficacy of acrylamido polyvinyl alcohol microspheres ( a-PVAM ) as an embolic agent for uterine artery embolization ( UAE ) compared with Tris-acryl gelatin microspheres ( TAGM ) . Design , Setting , Participants Prospect i ve r and omized double-blind noninferiority trial . Conducted at two sites both with regional UAE practice s. Forty-six women with symptomatic leiomyomas . InterventionUAE procedure was performed with either of the two embolic agents . Either 700–900-μm a-PVAM or 500–700-μm TAGM was used . Main Outcome Measures Changes in leiomyoma perfusion , overall uterine volume , and dominant leiomyomas volume measured by contrast-enhanced magnetic resonance imaging at 1 week , 3 months , and 6 months after UAE by a reader blinded to the embolic agent used . Changes in Uterine Fibroid Symptoms and Quality of Life question naire scores were measured at 3 , 6 , and 12 months after UAE . Results Forty-six patients were r and omized and treated under the study protocol ( a-PVAM n = 22 , TAGM n = 24 ) . There were no procedure-related complications . Two patients were excluded from analysis ( one technical failure of the procedure , one withdrawal from study ) . Successful ( > 90 % ) leiomyoma devascularization was observed in 81 % of subjects at 1 week after UAE , 97 % at 3 months after UAE , and 95 % at 6 months after UAE . No significant differences were observed in 14 of 15 outcome measurements , consistent with noninferiority . TAGM was slightly superior to a-PVAM on one comparison ( overall quality of life at 3 months after UAE ) PURPOSE To report the 12-month clinical and magnetic resonance ( MR ) imaging results of an ongoing two-center registry involving acrylamido polyvinyl alcohol ( PVA ) microspheres for  uterine artery embolization ( UAE ) for leiomyomas . MATERIAL S AND METHODS A total of 69 patients underwent UAE with 500 - 700-microm , 700 - 900-microm , and 900 - 1,200-mum acrylamido PVA microspheres ( BeadBlock ) . Thirty-three patients underwent UAE with a limited embolization ( protocol A ) and 36 patients underwent UAE with stasis as the angiographic endpoint ( protocol B ) . Primary objectives were clinical efficacy measured by a leiomyoma-specific quality of life ( QOL ) question naire and infa rct ion rate of leiomyomas on early contrast agent-enhanced MR imaging . Secondary objectives were in-hospital complications , patient satisfaction , and frequency of clinical failure . RESULTS Bilateral embolization was technically successful in 68 of 69 patients . A significant decrease ( P < .001 ) in symptom severity and increase in health-related QOL was observed at 3 and 12 months with no significant differences between embolization protocol s. However , contrast agent-enhanced MR imaging showed a significantly lower rate of completely infa rct ed leiomyomas in protocol A compared with protocol B ( P < 
    Output:
    
Results No evidence of superiority of any embolic agent was demonstrated .
Conclusions This study confirms that the current evidence demonstrates superiority of Embospheres over spherical PVA but no reported differences in outcomes between any of the other agents .