Midterm Outcome of Ultrasound-Guided Alcohol Gel Sclerotherapy for Symptomatic Leiomyoma

Abstract

The purpose of this study was to describe the outcome of ultrasound-guided ethanol gel sclerotherapy of myomatous nodules 1 to 18 months after treatment. A total of 118 consecutive patients with a diagnosis of symptomatic leiomyomas referred for ethanol gel sclerotherapy were studied between November 2005 and July 2007. Clinical (self-administered symptom questionnaire) and ultrasound follow-ups were done 1 to 2, 6 to 8, and 12 to 18 months after the procedure. The mean baseline volumes +/- SD were 223.3 +/- 158.3 cm(3) for the uterus and 68.4 +/- 110.5 cm(3) for the dominant fibroid. The most common adverse reaction in the immediate postoperative period was pelvic pain in 27.1% of the patients, but 58.4% had no reactions. After 12 months, a 29.5% reduction in uterine volume was observed in 64.7% of the patients. A 55.5% reduction in dominant fibroid volume was observed in 82.8% of the patients. Pelvic pain improved in 29.8% of the sample, dysmenorrhea in 51.7%, and menstrual flow in 39%. Most patients (77%) reported being satisfied or very satisfied with the treatment. The results suggest that ethanol gel sclerotherapy is a safe, conservative alternative for treating symptomatic uterine leiomyomas. Further randomized studies are necessary to determine the suitability and indications of this procedure in comparison to other minimally invasive techniques.