Clinical outcomes of uterine artery embolization and experience of postoperative transvaginal fibroid expulsion: a retrospective analysis

Wang, Ruo-Li; Fu, Qi-Tian; Jiang, Jian; Ruan, Dan-Dan; Lin, Jia-Li; Zhou, Yanfeng; Wu, Shao-Jie; Cai, Shun; Zhang, Jianhui; Luo, Jie‐Wei; Fang, Zuxiang

doi:10.1007/s00404-022-06407-5

Cited by 4 publications

(6 citation statements)

References 48 publications

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“…This is all the more important since the benign nature of the underlying condition means that complications can only be tolerated within very narrow limits. The most serious complication is definitely the secondary infection of the myoma or the uterus, possibly with the development of sepsis [ 32 , 33 , 34 ]. We analyzed the development of these values in 270 patients with a normal course in order to describe the course of these parameters after embolization treatment, which can be associated with quantitatively not insignificant tissue necrosis, even under normal conditions.…”

Section: Discussionmentioning

confidence: 99%

“…The frequency of UAE complications is very low. In general, the complications concern either the catheterization or the effects of the ischemia of the uterus that can cause necrosis of the fibroids with the appearance of a septic picture and their expulsion [ 8 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ]. Finally, embolization of other organs, especially the ovaries, can also occur.…”

Section: Discussionmentioning

confidence: 99%

“…Does a correlation exist between the fibroid volume and inflammatory factors [ 6 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ]?…”

Section: Discussionmentioning

confidence: 99%

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Our Experience with Hydrogel-Coated Trisacryl Microspheres in Uterine Artery Embolization for the Treatment of Symptomatic Uterine Fibroids and Adenomyosis: A Follow-Up of 11 Years

Tsikouras,

Oikonomou,

Tsatsaris

et al. 2023

JPM

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Uterine artery embolization (UAE) for the treatment of symptomatic uterine fibroids and non-controllable adenomyosis symptoms is a relatively new procedure for organ-preserving therapy. These benign conditions can become symptomatic in about 30% of women between the ages of 35 and 50. The purpose of the UAE either for fibroids or adenomyosis is the elimination of blood loss, the reduction in pain, and bulky or rectal pressure symptoms. The purpose of this study is to present our experience in UAE with the use of hydrogel-coated tris acryl microspheres for the treatment of symptomatic uterine fibroids and adenomyosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Our Experience with Hydrogel-Coated Trisacryl Microspheres in Uterine Artery Embolization for the Treatment of Symptomatic Uterine Fibroids and Adenomyosis: A Follow-Up of 11 Years

Tsikouras,

Oikonomou,

Tsatsaris

et al. 2023

JPM

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“…Traditional surgical treatments for symptomatic UFs include myomectomy and hysterectomy. However, for this common gynecological disease, minimally invasive surgery and image-guided ablation technology gradually occupied the dominant position in the treatment prospect, such as uterine artery embolization (UAE) with definitive efficacy and high safety and high intensity focused ultrasound (HIFU) guided by non-invasive ultrasound or magnetic resonance imaging (MRI)( 36 , 37 ). Compared with traditional laparoscopic myomectomy, HIFU guided by ultrasound can improve patients' quality of life more effectively, and it is helpful for the recovery and prognosis of hysteromyoma after treatment ( 38 ).…”

Section: Discussionmentioning

confidence: 99%

Global, regional, and national burden of uterine fibroids in the last 30 years: Estimates from the 1990 to 2019 Global Burden of Disease Study

Cheng

Gong

et al. 2022

Front. Med.

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ObjectiveTo study specific information on trends in incidence, mortality, disability-adjusted life years (DALY) and the corresponding trends among five sociodemographic index regions, 21 regions, and 204 countries for decision-making, which would enable policymakers to distribute limited resources and devise policies more rationally.MethodsData on uterine fibroids (UNs) from 1990 to 2019, including incidence, mortality, and DALYs, were obtained from the 2019 Global Burden of Disease Study. An estimated annual percentage change (EAPC) was calculated to assess morbidity, mortality, and DALY trends.ResultsThe incident cases of UFs increased from 5,769,658 (95%UI, 7,634,3995–4,274,824) incidences in 1990 to 9,643,336 (95%UI, 7,178,053-12,714,741) incidences in 2017, and the age-standardized incidence rate was steady at 225.67/100,000 persons (95%UI, 167.33–298.87) in 1990 to 241.18/100,000 persons (95%UI, 179,45–318.02) in 2019. The incidence ratio in the high sociodemographic index (SDI) region showed a unimodal distribution, with peaks in 2005. Between 2009 and 2017, the age-standardized death rate of UFs declined globally, especially in low-SDI and low-middle SDI regions. In contrast with 860,619 DALYs (95%UI, 473,067-1,505,289) in 1990, the number of DALYs was 1,378,497 (95%UI, 710,915-2,475,244) in 2019, which had increased significantly, whereas the age-standardized DALY rate decreased expressively with an EAPC of −1.93 (95%CI, from −2.16 to −1.71).ConclusionThe global burden of UFs increased between 1990 and 2019, and the incidences and DALYs increased prominently worldwide, while the deaths from UFs had no evident growth. Lower SDI regions carried an incremental burden of UFs, while disease reduction was observed in higher SDI regions. It is high time we paid attention to the underprivileged regional quality of life and health protection.

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“…UAE is typically preferred over myomectomy as it has a shorter hospital stay and faster recovery rate 7 , 8 but has an increased possibility of re-intervention 9 which can be troublesome for most patients. However, myomectomy is more beneficial in improving patients’ quality of life; this equally is a favorable long-term asset in the lives of fibroid patients.…”

Section: Introductionmentioning

confidence: 99%

Uterine artery embolization versus myomectomy: a systematic review and meta-analysis

Fatima,

Ansari,

Ejaz

et al. 2024

SAGE Open Medicine

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Introduction: Uterine fibroids are the commonest benign tumors of the reproductive tract in women of childbearing age. They are usually asymptomatic but can cause menorrhagia. Treatments include myomectomy and uterine artery embolization (UAE). The latter is a relatively new procedure, therefore of special interest. Objectives: We conducted a systematic review and meta-analysis of all published studies to provide a comprehensive outlook on the effectiveness of UAE by comparing its outcomes to those of myomectomy. Electronic databases (PubMed and Cochrane Central) were systematically searched from January 2000 to March 2022 for published randomized control trials, observational studies, and meta-analyses that compared UAE to myomectomy for at least one of the pre-specified outcomes, namely re-intervention rates, length of hospital stay, and complications. Methods: We shortlisted nine studies for the final analysis. For continuous outcomes, results from random-effects meta-analysis were presented as mean differences (MDs) and corresponding 95% confidence intervals (CIs). Risk ratios (RRs) for dichotomous outcomes were pooled using a random-effects model. Results: The final analysis consisted of nine studies. Factors like re-intervention, hospitalization, and complications, each with its unique follow-up duration were assessed. Pooled analysis demonstrated significant results for greater re-intervention rates with UAE as compared to myomectomy (RR: 2.16, 95% CI: (1.27–3.66), p-value 0.004, heterogeneity I2 = 85%). UAE holds a greater but statistically insignificant risk for major complications (RR: 0.62, 95% CI: (0.29–1.33), p-value 0.22, heterogeneity I2 = 0%) and myomectomy shows a statistically insignificant greater risk for minor complications (RR: 1.72, 95% CI: (0.92–3.22), p-value 0.09, heterogeneity I2 = 0%). UAE had a shorter but statistically insignificant duration of hospital stay (MD: −1.12, 95% CI: (−2.50 to 0.27), p-value 0.11, heterogeneity I2 = 96%) ( p-value for subgroup differences = 0.005). Conclusion: Our meta-analysis of approximately 196,595 patients demonstrates that myomectomy results in a significant reduction in re-intervention rate compared to UAE.

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Clinical outcomes of uterine artery embolization and experience of postoperative transvaginal fibroid expulsion: a retrospective analysis

Cited by 4 publications

References 48 publications

Our Experience with Hydrogel-Coated Trisacryl Microspheres in Uterine Artery Embolization for the Treatment of Symptomatic Uterine Fibroids and Adenomyosis: A Follow-Up of 11 Years

Our Experience with Hydrogel-Coated Trisacryl Microspheres in Uterine Artery Embolization for the Treatment of Symptomatic Uterine Fibroids and Adenomyosis: A Follow-Up of 11 Years

Global, regional, and national burden of uterine fibroids in the last 30 years: Estimates from the 1990 to 2019 Global Burden of Disease Study

Uterine artery embolization versus myomectomy: a systematic review and meta-analysis

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