Role of Uterine Artery Embolization in Management of Uterine Lesions with Abnormal Uterine Bleeding

Abstract

Introduction: Abnormal uterine bleeding is one of the most frequent gynecological and obstetrics problems. Till the recent decades, myomectomy and hysterectomy were the only treatment options available to control uterine bleeding regardless the morbidity and mortality. Over the past decade, uterine artery embolization (UAE) has become a popular alternative treatment. Our study aim is to evaluate the efficacy of UAE for the treatment of uterine bleeding of different etiologies as Fibroids & uterine arterio-venous malformation (AVM). Material & Methods: Thirty patients were enrolled in the study: 28 patients with fibroids & 2 patients with AVM, all underwent UAE by PVA for fibroid & Hystroacryl with lipidol & coils for AVM. Bleeding as an end point was Followed up for 6 months. Results: Cessation of bleeding with no recurrence through the 6 months of follow up. UAE significantly decreased the bleeding towels from 4.4 to 2 towels after 6 months. As well, the menstrual duration was reduced from 7.6 to 4.4 days (p < 0.05*). Hemoglobin level was boosted from 10.7 to 11.4 gm/dl after 6 months (p=0.001*). As well, the fibroid size was significantly reduced from 314.7 to 70.4 cm3 after 6 months (p < 0.05*). The AVM cases have completely recovered & one of them got pregnant with delivery of normal fetus with no reported complication. The majority of our patients showed high level of satisfaction with the obtained outcomes. Conclusion: UAE, either unilateral or bilateral, is a safe and effective technique for management of abnormal uterine bleeding of fibroids & AVM origin. A high clinical success rate and fibroid volume with the mean menstrual duration& amount reduction can be achieved.