Efficacy of uterine artery embolisation for treatment of symptomatic fibroids and adenomyosis – An interim report on an <scp>A</scp>ustralian experience

Liang, Eisen; Brown, Bevan; Kirsop, Rodney; Stewart, Paul; Stuart, Andrew

doi:10.1111/j.1479-828x.2011.01399.x

Cited by 37 publications

(21 citation statements)

References 12 publications

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“…Since 2000—associated with the introduction of treatments such as the levonorgestrel-releasing intrauterine system (Mirena™) and second-generation endometrial ablation techniques—the rate of hysterectomy has fallen [ 4 ]. Over the same period nonsurgical treatments for fibroids such as uterine artery embolization and focussed ultrasound also might be expected to reduce further the rate of hysterectomy [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Changes in Hysterectomy Route and Adnexal Removal for Benign Disease in Australia 2001–2015: A National Population-Based Study

Cure

Robson

2018

Minimally Invasive Surgery

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Objective Hysterectomy rates have fallen over recent years and there remains debate whether salpingectomy should be performed to reduce the lifetime risk of ovarian cancer. We examined trends in adnexal removal and route of hysterectomy in Australia between 2001 and 2015. Methods Data were obtained from the national procedural dataset for hysterectomy approach (vaginal, VH; abdominal, AH; and, laparoscopic, LH) and rates of adnexal removal, as well as endometrial ablation. The total female population in two age groups (“younger age group,” 35 to 54 years, and “older age group,” 55 to 74 years) was obtained from the Australian Bureau of Statistics. Results The rate of hysterectomy fell in both younger (61.7 versus 45.2/10000/year, p < 0.005) and older (38.8 versus 33.2/10000/year, p < 0.005) age groups. In both age groups there were significant decreases in the incidence rates for VH (by 53% in the younger age group and 29% in the older age group) and AH (by 53% and 55%, respectively). The rates of LH increased by 153% in the younger age group and 307% in the older age group. Overall, the proportion of hysterectomies involving adnexal removal increased (31% versus 65% in the younger age group, p < 0.005; 44% versus 58% in the older age group, p < 0.005). The increase occurred almost entirely after 2011. Conclusion Hysterectomy is becoming less common, and both vaginal and abdominal hysterectomy are being replaced by laparoscopic hysterectomy. Removal of the adnexae is now more common in younger women.

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Section: Introductionmentioning

confidence: 99%

Changes in Hysterectomy Route and Adnexal Removal for Benign Disease in Australia 2001–2015: A National Population-Based Study

Cure

Robson

2018

Minimally Invasive Surgery

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“…The amount of leiomyomatous proliferation in our case was significant and prominent. In retrospect, recommending uterine artery embolization (UAE) pretransplant would have been very beneficial for this patient, as studies have shown this procedure carries > 90% success rates in reducing the sizes of, and pain from, fibroids and menorrhagia [16]. Care needs to be taken, however, during the approach for UAE because the main access to the internal iliac artery for embolization is via the contralateral femoral artery and external iliac artery.…”

Section: Discussionmentioning

confidence: 99%

Massive Leiomyomatous Uterine Proliferation Following Kidney Transplantation: A Case Report and Literature Review

Minja

Tan

Gibbs

et al. 2018

Case Reports in Transplantation

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Uterine fibroids are the most common benign uterine tumors affecting > 50% of premenopausal women. The incidence, burden and symptoms from uterine fibroids are higher in women of African descent compared to Caucasians. Despite increasing number of African American females being evaluated for and undergoing kidney transplantation (KT), perioperative management guidelines for uterine fibroids currently do not exist. We present a case of a 40 y/o African American female with known symptomatic uterine fibroids preoperatively and medically managed, who underwent a successful KT and 4 years later progressively developed massive leiomyomatous uterine proliferation, causing a complete lateral displacement of the transplanted kidney with severe hydronephrosis, transplant ureteral obstruction and secondary urinary tract infections with bacteremia. This obstruction required a percutaneous nephrostomy tube placement followed by an interval transabdominal hysterectomy, which was complicated by transplant ureteral transection requiring ureteral reimplantation, resulting in prolonged hospitalization, follow-up and outpatient antibiotic regimen. There is a need for management guidelines for uterine fibroids incidentally encountered during the KT evaluation process to avoid similar preventable post-KT complications in patient populations most commonly affected. Literature review and perioperative management/surveillance strategies are provided.

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“…Interventional radiologists will also need to take greater clinical ownership for post‐procedural care and this involves having an inpatient bedcard and continuing to post‐operatively manage their patient. These issues form a major hurdle for the provision of these services in many public hospitals …”

Section: The Australian Experiencementioning

confidence: 99%

Treatment of symptomatic fibroid disease using uterine fibroid embolisation: An Australian perspective

Clements

Ang

Law

et al. 2020

Aust NZ J Obst Gynaeco

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Uterine leiomyomata (fibroids) are symptomatic in up to 35% of women and treatment can be a costly burden to the individual and society. Options for treatment range from non‐hormonal, hormonal, minimally invasive, to surgery. While symptoms from smaller fibroids may respond to simple treatment, those with larger fibroids or with a large volume of disease require a more definitive option. Surgery (hysterectomy or myomectomy) are both well‐established treatment modalities with good clinical outcomes. Since the 1990s, uterine fibroid embolisation has emerged as a less invasive option for women than for surgical techniques, while level 1 evidence shows that in the short to mid‐term, there is a similar improvement in symptom‐related quality of life outcomes to surgery, but with reduced hospital stay and reduced cost. However, in the longer term there may be a need for further treatment or retreatment in some patients compared with surgery. Since its introduction, uptake of this procedure in Australia has been low relative to surgical options. This manuscript reviews the current literature surrounding treatment, along with the trends in uptake of embolisation by Australian women, places this in context of current guidelines from major societies, and encourages gynaecologists and interventional radiologists to be aware of the advantages and limitations of embolisation.

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Efficacy of uterine artery embolisation for treatment of symptomatic fibroids and adenomyosis – An interim report on an Australian experience

Abstract: This audit, based on local Australian experience, has confirmed that UAE is a safe and highly effective treatment for women with symptomatic fibroids and/or adenomyosis.

Cited by 37 publications

References 12 publications

Changes in Hysterectomy Route and Adnexal Removal for Benign Disease in Australia 2001–2015: A National Population-Based Study

Changes in Hysterectomy Route and Adnexal Removal for Benign Disease in Australia 2001–2015: A National Population-Based Study

Massive Leiomyomatous Uterine Proliferation Following Kidney Transplantation: A Case Report and Literature Review

Treatment of symptomatic fibroid disease using uterine fibroid embolisation: An Australian perspective

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