Journal of epidemiology and population health · 2026
Geographic and population-based analysis of surgical and embolization treatments for uterine fibroids in France (2011-2022): assessing utilization and access.
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de Oliveira Fabien, Léger Lucas, Debeauvais Agathe, Serrand Chris, Beregi Jean-Paul, Lamouroux Audrey, Boudemaghe Thierry, Letouzey Vincent, Frandon Julien
Аннотация
INTRODUCTION: Uterine fibroids are the most common benign tumors in women and can be treated through various surgical and minimally invasive procedures. This study aimed to describe the utilization of surgical and embolization treatments for uterine fibroids in France. Secondary objectives were to analyze their geographic distribution and investigate potential associations between the different treatment techniques.
METHODS: This study used exhaustive data from the French national hospital discharge database (Programme de Médicalisation des Systèmes d'Information, PMSI) for the years 2011 to 2022. Women aged 15 to 99 years with a diagnosis of uterine fibroids and a hospital stay for myomectomy, hysterectomy, or uterine artery embolization were included. Patient characteristics and treatment facility locations were collected. Procedure rates were geographically estimated. Associations between treatment techniques were analyzed using linear regression.
RESULTS: Among 633,506 hospitalizations for uterine fibroids, 48.4% involved hysterectomy, 30.3% myomectomy, and 2.5% embolization. Patient age, length of hospital stay, and rehospitalization timing varied by treatment. Marked regional disparities were observed in procedure rates. A strong inverse association was identified between hysterectomy and the use of alternative treatments (R² = 0.77). In-hospital mortality was low across all groups.
CONCLUSION: National hospital discharge data can be used to describe the distribution of uterine fibroid treatments in France. Hysterectomy remains the most frequently performed procedure, but significant regional disparities suggest unequal access to minimally invasive alternatives such as myomectomy and embolization.
METHODS: This study used exhaustive data from the French national hospital discharge database (Programme de Médicalisation des Systèmes d'Information, PMSI) for the years 2011 to 2022. Women aged 15 to 99 years with a diagnosis of uterine fibroids and a hospital stay for myomectomy, hysterectomy, or uterine artery embolization were included. Patient characteristics and treatment facility locations were collected. Procedure rates were geographically estimated. Associations between treatment techniques were analyzed using linear regression.
RESULTS: Among 633,506 hospitalizations for uterine fibroids, 48.4% involved hysterectomy, 30.3% myomectomy, and 2.5% embolization. Patient age, length of hospital stay, and rehospitalization timing varied by treatment. Marked regional disparities were observed in procedure rates. A strong inverse association was identified between hysterectomy and the use of alternative treatments (R² = 0.77). In-hospital mortality was low across all groups.
CONCLUSION: National hospital discharge data can be used to describe the distribution of uterine fibroid treatments in France. Hysterectomy remains the most frequently performed procedure, but significant regional disparities suggest unequal access to minimally invasive alternatives such as myomectomy and embolization.