Abstract
The purpose of this study was to evaluate safety, efficacy or complications of uterine artery embolization (UAE). Patients with symptomatic uterine fibroids (n = 157) were treated by selective bilateral UAE using 350–500 μm sized polyvinyl alcohol particles. Bilateral UAE was successful in 152 (96.8%) cases. Baseline measures of clinical symptoms and MRI taken before the procedure were compared to those taken 3, 6, and 12 months after embolotherapy. Also, complications and outcomes were analyzed after procedure. All patients had an uneventful recovery and were able to return to normal activity within two weeks of embolization. After the procedure, most patients experienced crampy pelvic pain, of variable intensity, which was well managed with the standard analgesia protocol. Five (3%) of participants had persisting amenorrhea after procedure. None reported any new gynecologic or medical problem during the follow-up period. There were no deaths and no major permanent injuries. Reductions in mean uterine volume were 61% (P < 0.01) and in dominant fibroid volume 66% (P≤0.01). The follow-up showed significant improvement of bleeding. In conclusion, uterine artery embolization is a successful, minimal invasive treatment of uterine fibroids that preserves the uterus, had minimal complications, and requires short hospitalization and recovery.
Highlights
Uterine fibroids are benign tumours of smooth muscle cells and fibrous connective tissue that develop within the walls of the uterus
Symptomatic fibroids have been treated with myomectomy or hysterectomy performed by laparotomy [1, 2]
The most significant therapeutic innovation has been the advent of uterine artery embolization (UAE) as a form of nonsurgical management
Summary
Uterine fibroids (leiomyomata or myomas) are benign tumours of smooth muscle cells and fibrous connective tissue that develop within the walls of the uterus. They are the most common gynaecological problem experienced by women, being of clinical significance in 20–40% of women of childbearing age. Symptomatic fibroids have been treated with myomectomy or hysterectomy performed by laparotomy [1, 2]. The most significant therapeutic innovation has been the advent of uterine artery embolization (UAE) as a form of nonsurgical management. The desire to avoid a hysterectomy under any circumstances is an absolute contraindication to UAE.
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