Clinical Efficacy and Complications of Uterine Artery Embolization in Symptomatic Uterine Fibroids

Abstract

We decided to evaluate the efficacy and complications of uterine artery embolization (UAE) in patients with symptomatic uterine fibroids. Sixty-five premenopausal patients, without considering the fibroids size and its location, were treated by bilateral UAE. At baseline and after 3, 6, and 12 months MRI was obtained to determine the uterine length and fibroid diameter. In addition, symptoms of the patients were documented at these follow-up schedules. UAE was successful in 62 (95.4%) cases. Complete infarction rate of the fibroid was 83.1%. After 12 months, the uterine length showed a decrease of 55.7% (mean of 9.4 cm) and the diameter of the dominant fibroid revealed a decrease of 52.1% (mean of 3.4 cm). Menorrhagia improved in 45 cases (91.8%), abdominal mass in 24 cases (82.28%), urinary symptoms in 17 cases (85%), pelvic pain in 21 cases (84%), and dysmenorrhea in 25 cases (80.6%). At final follow-up performed after one year, complete infarction of the fibroma was demonstrated in 49 patients (83.1%). Two cases achieved successful pregnancy in the one year follow-up period. Five patients developed post-embolization syndrome which necessitated admission to the hospital. Twenty-two patients presented and complained of pain for which outpatient pain management was done. UAE was a successful treatment for uterine fibroids that preserved the uterus, had minimal complications, and required short hospitalization and recovery.

Adverse effect analysis of high-intensity focused ultrasound in the treatment of benign uterine diseases

“…The major adverse effects (Class C&D) were only seen in 104 patients, which account for 0.79% (104/13,170). The rate of major adverse effects was lower than that of other treatment modalities [14][15][16][17]. Table 3 showed that the common minor adverse effects observed in this study were mild lower abdominal pain, sacrococcyygeal pain, and abnormal vaginal discharge.…”

Long-term efficacy of uterine artery embolization in the treatment of symptomatic uterine fibroids and its effect on ovarian reserve

“…Median takip süresi 7 yıl olan bir çalışmada, UAE sonrası hastaların ağrı yakınmasındaki düzelme %78,9 olarak bulunmuştur (19) . UAE işlemi sonrası ağrı ve kanama yakınmasındaki belirgin düzelme, hastaların yaşam kalitelerine olumlu yansımaktadır (20) . Sonuç olarak, 1.278 hastanın 3 yıl takip edildiği çok merkezli bir çalışmada, hastalarda semptom skorunun %85,3 iyileşme ile uzun dönemde sürdürülebilir bir iyileşme olduğunu ortaya koymuştur (12) .…”

Embolization-induced Renal Tumor Shrinkage Followed by Definitive Cryoablation

“…Performing cryoablation several months post-embolization allows for adequate tumor shrinkage, as well as recovery of renal function [ 10 ]. Similarly, to achieve adequate post-bland embolization shrinkage for other tumors such as uterine fibroids, two months between procedures is usually adequate to achieve the desired size reduction [ 4 ].…”

“…Bland arterial embolization is currently used to debulk tumors such as uterine fibroids as well as hyperplastic tissue such as that found in benign prostatic hyperplasia [ 4 - 5 ]. This is accomplished using fluoroscopy by selectively embolizing the feeding vessels of these structures which results in ischemia followed by shrinkage.…”