PII: S0029-7844(00)00615-3

Abstract

Objective: To examine the use of uterine artery embolization as an alternative primary treatment for the large fibroid uterus.Methods: Patients with a large fibroid uterus (at least 13 weeks in size) were randomized into two groups to undergo uterine artery embolization with Gelfoam or PVA, via a transfemoral arterial approach. Response was measured in change in fundal height and in subjective improvement in symptoms.Results: During a 2-year period from 1997 to 1999, 29 women whose primary complaints included menorrhagia/metorrhagia (13/29), pelvic pain (8/29), increased abdominal girth (4/29), urinary frequency (2/29), and dyspareunia (2/29) were enrolled in the study. As a result of embolization, there was a mean decrease in uterine volume of 46% and a mean decrease in the volume of the dominant myoma of 52%. No significant association between primary complaint and preprocedural or postprocedural fundal height was observed. More than 86% of patients reported a subjective improvement in symptoms. This was found to be significantly associated with postembolization fundal height (P = 0.008), as well as with change in fundal height (P = 0.023). Subjective improvement also was associated with lower preembolization fundal height (P = 0.07). There was no significant relationship between primary complaint and subjective improvement in symptoms.Conclusions: Uterine artery embolization is a useful tool for the treatment of large fibroids, providing women with relief of symptoms.