Abstract No. 256 - Uterine and dominant fibroid volume and particle volume as predictors of pain and post embolization syndrome following uterine fibroid embolization

Abstract

Purpose Uterine fibroid embolization (UFE) is now a common procedure performed for treatment of symptomatic leiomyomata. Immediate post procedure pelvic pain and cramping is the most common reported complaint following treatment. Post embolization syndrome consisting of nausea, vomiting, and/or low grade fever also commonly affects the post procedure recovery. The purpose of this study is to evaluate if the total uterine volume, dominant fibroid volume, or volume of particles administered can be used as a predictor for pain and post embolization syndrome in the immediate post procedural recovery. Previous studies have demonstrated that post procedure pain is not easily predicted by uterine or fibroid volume. Materials and Methods This is a single center trial consisting of 82 patients who underwent UFE in a standard manner from March 2010 - March 2011. Measurement of uterine volume and dominant fibroid volume was obtained prior to procedure. 500-700 micrometer (um) and/or 700-900 um trisacryl gelatin microspheres (Embospheres) were utilized to achieve stasis or near stasis of blood flow. During a 23-hour observation period, patients and nurses completed a Data Collection Form at 1 hr, 2 hr, 4 hr, 8 hr, and 16 hr (+/- 15min each). Post procedural pain was defined by the total dose of fentanyl received and standardized relative to each patient’s body mass index (micrograms fentanyl/bmi). Results Regression analysis were utilized to independently compare the fentanyl dose per body mass index with the total volume of embospheres used, the total uterine volume, and the dominant fibroid volume as predictors of post procedural pain. These analysis demonstrate no correlation between the fentanyl dose/bmi relative to the total volume of embospheres utilized, the total uterine volume, or the dominant fibroid volume. Conclusion Post procedural pain following UFE is a complex process which has proven difficult to predict. This study demonstrates no statistical correlation between post UFE pain and the volume of embospheres utilized, the total uterine volume, or the dominant fibroid volume. These findings reinforce similar results from previously published data.