The role of uterine artery embolization in management of abnormal uterine bleeding

Abstract

Background:Abnormal uterine bleeding is a common presenting symptom in the family practice setting. The most common causes are uterine fibroids, dysfunctional uterine bleeding and adenomyosis. All conditions were accompanied by chronic blood loss disabling normal lifestyle with variable degrees of morbidity.Objectives: This study is aiming to evaluate the safety, efficacy, and complications of uterine artery embolization(UAE) in the management of abnormal uterine bleeding (AUB)in different age groups. Patients and Methods: This a prospective randomized clinical trial prospective study included 20 patients referred for UAE. Twelve patients had uterine fibroids, 4 patients had adenomyosis and other 4 patients were diagnosed as dysfunctional uterine bleeding. The embolizing materials were used includingPolyvinyl alcohol, Tris-acryl gelatin microspheresand gelatin sponge. All patients had AUB. Results: Most patients showed good therapeutic responses through the follow up period (6-12 months). Complete control of bleeding was achieved in 90% of patients and recurrence occurred only in 10%. There was complete improvement of the pelvic pain and bulk related symptoms. Reduction of uterine and fibroid size occurred with average uterine and dominant fibroid volumes loss of 39%, and 57% respectively. However, the reduction in the Junctional zone thickness was 5.6 %. Conclusion: UAE is considered minimally invasive, safe, and effective method that plays an important role in treatment of variable types of AUB causes, aiming for uterine preservation and avoiding hysterectomy giving the chance for future fertility. It has high success rate with obvious low morbidity and mortality rates.