Abstract
Uterine leiomyoma, a benign tumor, may be treated with hormone therapy, conventional surgical resection and uterine artery embolization (UAE): this paper reports the study on safety after UAE treatment. Pregnancy processes and prognoses of a total of 41 cases from 39 patients (two women were pregnant twice) who succeeded to pregnancy after UAE treatment in our clinic were studied. The average age of patients was 34.5 (29 - 40). Patients included 24 cases of multiple uterine leiomyoma and 14 cases of solitary leiomyoma; the average size of leiomyoma was 388.3 cm3 (15 - 1059 cm3) and the average period between UAE operation and pregnancy was 26.5 months (1 - 120). Causes of pregnancy were 29 cases of natural pregnancy and 12 cases of infertility treatment: 28 cases succeeded in delivery, 7 cases resulted in spontaneous abortion, and 6 cases are ongoing. Premature birth, placental abnormality and low-weight babies were observed in 3, 3, and 1 cases, respectively; the latter 1 case was of triplets. Although the incidence of placental abnormality was a little high, no other serious complications were observed, suggesting that pregnancy after UAE has no problem from the obstetric point of view. In the future, UAE is considered to be worthwhile if carefully done for cases who want to become pregnant.
Highlights
A benign tumor, may be treated with hormone therapy, conventional surgical resection and uterine artery embolization (UAE): this paper reports the study on safety after UAE treatment
UAE was done after obtaining enough “understanding and consent” from patients who wish for UAE on the understanding that as a treatment of uterine leiomyoma they can choose a treatment among the methods of surgical removal, UAE, hormonal therapy, etc
Multiple cases tended to be slightly more frequent with only 3 cases of gigantic fibroids that developed beyond the umbilical region. - Size of uterine leiomyoma: average 388.3 ± 283.8 cm3 (15 - 1059 cm3). - Major uterine leiomyoma sites: 0 case was subserous, 18 cases were intramuscular, 18 cases were submucosal, 3 cases were cervical. - Reduction rate of uterine leiomyomas one year after UAE: average reduction rate was 59.2 ± 21.4% (95.0% - 0%) In 2 cases the uterine leiomyoma disappeared after UAE. - The term between UAE and pregnancy: average 26.5 ± 29.9 months (1 month - 120 months)
Summary
Other than medical and surgical therapies, a method to treat leiomyoma by em-. This uterine artery embolization (UAE) has gradually been accepted as an option to treat uterine leiomyoma. The following points are raised as advantages of UAE: at first preservation of the uterus, followed by a reduced physical and economic burden, and absence of surgical blood loss, intraperitoneal adhesion and postoperative scarring, etc. In Japan, surgical therapy is selected overwhelmingly to treat uterine leiomyoma. Most patients who visit our clinic eagerly want to keep the uterus or do not want surgery itself after they know the existence of UAE via the social network service
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