Optimizing Fibroid Infarction Rates after Uterine Artery Embolization

The Contribution of Uterine Artery Embolization as a Safe Treatment Option for Uterine Fibroids

“…Uterine size does not appear to be a determinant, as remission of symptoms is also common in patients with a uterus greater than 24 weeks gestation. These results are also confirmed by studies of the last four years, which show that patients are 98-1000% satisfied [67,75,76,[87][88][89][90]. UAEs also have a beneficial effect in cases of adenomyosis, although there is not much experience.…”

“…In a series of 28 patients with genuine adenomyosis an improvement of 95.3% was recorded [67,75,76,[87][88][89][90]. Although there are no long-term data, follow-up of up to 72 months shows postembolization syndrome include: pain and cramps (eliminated in the first hours after procedure with good/systemic analgesic treatment), nausea and fever (controlled with appropriate medications), aseptic or (rarely) septic inflammation (in a few patients, total 4 in our study controlled with anti-inflammatory/antibiotics) for 3-6 months) or (rare) menopause after UAE (small number of patients, almost always aged>45 years) [67,75,76,[87][88][89][90]. In these cases were diagnosed large fibroids and the reported complications affect range according to published literature 2-15% needed readmission for monitoring of symptoms.…”

“…The reported deaths following UAE are extremely rare (approximately 1: 1600) and are mainly related to pulmonary embolism, which may be due to the effect of necrotic tissue on activation of the coagulation mechanism and on inflammation. The complications of catheterization are rare (<1%), such as hematoma, allergy to contrast media and pseudo-aneurysm or vascular separation [75,76,[87][88][89][90]. Elimination of uterine fibroids occurs in 5% of cases and can cause inflammation requiring scanning or hysterectomy.…”

“…The necrotic tissue, if not removed in time, can become infected and the condition becomes severe. Cases with submucosal fibroids should be treated hysteroscopically [75,76,[87][88][89][90]. Ischemia may cause endometritis, pelvic inflammation and pyometra with poor outcome if hysterectomy does not occur.…”

“…Ischemia may cause endometritis, pelvic inflammation and pyometra with poor outcome if hysterectomy does not occur. According to the literature, menorrhagia is successfully treated in 91-100% of cases, while symptoms such as flatulence, pressure on organs of the pelvis and loss of urine are reduced to 92-100% [67,75,76,[87][88][89][90]. Uterine size does not appear to be a determinant, as remission of symptoms is also common in patients with a uterus greater than 24 weeks gestation.…”