4:21 PM Abstract No. 174 Uterine artery embolization for fibroids versus fibroids and adenomyosis

Abstract

To compare outcomes following uterine artery embolization (UAE) for patients with fibroids versus those with fibroids and adenomyosis A total of 145 patients underwent UAE at a single institution between August 2016 and June 2019. A retrospective review was performed of patient demographics, pre procedure MRI findings, and post procedure clinical and MRI outcomes. Statistical analysis was used to compare patients with fibroids only versus those with a combination of fibroids and adenomyosis. Eight patients were excluded due to lack of complete MRI studies available in PACS. Of the eligible patients, 103 had fibroids only and 34 patients had a combination of fibroids and adenomyosis. 81.4% of patients in the fibroid only group presented with menorrhagia vs. 91.2% in the combination group (P = 0.179). Significantly fewer patients with combination fibroids and adenomyosis presented with bulk symptoms, 67.6% vs. 85.1% in the fibroids only group (P = 0.025). There was no difference in demographics, uterine volume (P = 0.727) or amount of embolic material used during the UAE (P = 0.092) between groups. Clinical follow-up was available for 72 fibroid only patients and 23 combination patients with no difference in outcomes between the two groups. Menorrhagia improved in 91.4% of the fibroid only group vs. 82.6% in the combination group (P = 0.236) and bulk symptoms improved in 81.9% of the fibroid only group vs. 94.4% in the combination group (P = 0.191). Post-procedure MRI was available for 58 fibroid only patients and 15 combination patients and demonstrated no significant difference in the degree of nonenhancement (NE) when graded on a 4 tier scale of 100% NE, >90% NE, >80% NE and <80% NE (P = 0.226). Of the patients with adenomyosis, 86.7% (13/15) had improvement in the appearance of adenomyosis on post procedure MRI. This demonstrates that the presence of adenomyosis does not have an impact on the clinical or imaging success rate of uterine artery embolization when treating patients with a combination of fibroids and adenomyosis.