Efficacies of uterine artery embolization for symptomatic uterine fibroids using gelatin sponge: a single-center experience and literature review

Abstract

AimThe aim of this study was to retrospectively analyze the efficacies of uterine artery embolization (UAE) using gelatin sponge for symptomatic uterine fibroids.MethodsA series of 60 consecutive premenopausal women underwent UAE using gelatin sponge particles or porous gelatin particles. Patients were routinely followed up at 1, 3, 6, and 12 months after the procedure and asked to report any procedure-related complications. At each follow-up, an original clinical questionnaire was completed by the patients to evaluate changes in fibroid-related symptoms. Pelvic magnetic resonance imaging was performed before and at 3 and 12 months after the procedure, and the changes in volume of the dominant fibroid were calculated.ResultsBilateral UAE was successfully performed in all the patients. Median age was 45 years (range 34–53 years), and median follow-up period was 25.2 months (range 1–116 months). At the 3- and 12-month follow-up, the dominant fibroid volumes were found to be significantly decreased by 33.4% (95% confidence interval [CI]: 24.9–41.1) and 48.4% (95% CI: 40.7–56.1) compared to baseline volumes, respectively. Excluding patients not having menorrhagia or bulk-related symptoms, at 12 months 49 of 50 (98%) women showed improvement in menorrhagia, and 45 of 47 (95.7%) women showed improvement in bulk-related symptoms. During the follow-up period, ten patients (16.7%) required further interventions including two patients who had undergone hysterectomy. No sequelae were experienced by any of the patients.ConclusionUAE using gelatin sponge was associated with a high clinical success rate and good fibroid volume reduction compared to UAE using other embolic agents.

Initial experience with HydroPearl microspheres for uterine artery embolization for the treatment of symptomatic uterine fibroids

“…The observed rate of clinical response that we observed, for both menorrhagia and bulk symptoms, for HydroPearl Microsphere particles was overall similar to other previously studied embolic agents for UAE. These include polyvinyl alcohol with or without gelfoam, polyphosphazene- coated hydrogel microspheres (Embozene, Varian Medical, Palo Alto, CA), tris-acryl gelatin spheres (Embospheres and Embogold, Merit Medical, South Jordan, UT), and gelatin sponge particles/porous gelatin particles (Toda et al, 2016 ; Salehi et al, 2015 ; Stampfl et al, 2011 ; Joffre et al, 2004 ; Lohle et al, 2006 ).…”