Uterine artery embolization for the treatment of uterine fibroids (original) (raw)
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Seminars in interventional radiology, 2008
Uterine artery embolization (UAE) evolved as a treatment for symptomatic uterine fibroids in the early 1990s, after initially being used as a temporizing measure prior to hysterectomy or myomectomy. Since that time, over 100,000 UAEs have been performed. Technical success rates have been quoted ranging from 94 to 99%. The overall incidence of major complications associated with the procedure is low, the majority of which can be prevented. Knowledge of the potential complications and the measures that can be taken to avoid these complications is essential. Furthermore, because UAE is a relatively new procedure, no standardized recommendations for patient follow-up exist. Common practice for patient follow-up includes both clinic visits at increasing time intervals postprocedure, as well as telephone follow-up, and imaging follow-up when necessary. As symptomatic improvement is subjective, some institutions have developed standardized questionnaires to better assess patient improvemen...
The Contribution of Uterine Artery Embolization as a Safe Treatment Option for Uterine Fibroids
2020
Uterine fibroids have remarkably heterogeneous clinical characteristics with unknown exact etiology. The treatment of fibroids should be individualized based on their size, location, growth rate, the symptoms that they cause, the desire to have children and the age of the woman. Embolization is currently the most advanced non-surgical technique. The majority of women report satisfactory post-treatment results like shorter hospitalization period and recovery time in comparison to hysterectomy and improvement or complete remission of clinical symptoms. Complications include amenorrhea (in the majority of cases: recurrence after three months) and infections that are generally treated with antibiotics. The results from most clinical studies and our published experience indicate that embolization improves pelvic symptoms related to uterine fibroids. Collaborative efforts between gynecologists and interventional radiologists are necessary in order to optimize the safety and efficacy of th...
Uterine Artery Embolization as Nonsurgical Treatment of Uterine Myomas
ISRN Obstetrics and Gynecology, 2011
The purpose of this study was to evaluate safety, efficacy or complications of uterine artery embolization (UAE). Patients with symptomatic uterine fibroids (n = 157) were treated by selective bilateral UAE using 350-500 µm sized polyvinyl alcohol particles. Bilateral UAE was successful in 152 (96.8%) cases. Baseline measures of clinical symptoms and MRI taken before the procedure were compared to those taken 3, 6, and 12 months after embolotherapy. Also, complications and outcomes were analyzed after procedure. All patients had an uneventful recovery and were able to return to normal activity within two weeks of embolization. After the procedure, most patients experienced crampy pelvic pain, of variable intensity, which was well managed with the standard analgesia protocol. Five (3%) of participants had persisting amenorrhea after procedure. None reported any new gynecologic or medical problem during the follow-up period. There were no deaths and no major permanent injuries. Reductions in mean uterine volume were 61% (P < 0.01) and in dominant fibroid volume 66% (P ≤ 0.01). The follow-up showed significant improvement of bleeding. In conclusion, uterine artery embolization is a successful, minimal invasive treatment of uterine fibroids that preserves the uterus, had minimal complications, and requires short hospitalization and recovery.
Fibroids treated by uterine artery embolization: A review
Acta Obstetricia et Gynecologica Scandinavica, 2000
An increasing number of reports indicate that uterine fibroids can be successfully treated with uterine artery embolization (UAE). UAE seems to be a promising treatment for women who want to retain their uterus. This review summarizes the technical considerations and the results. UAE is a radiological procedure using angiography for visualization of the blood circulation. Subsequently, the flow through the uterine arteries is blocked resulting in infarction of fibroids. Success rates of 87% have been achieved with an average 57% reduction of fibroid volume. Complications have been few compared to hysterectomy and patient satisfaction is high. However, none of the reports include controls. Further studies are needed to optimize patient selection and to evaluate long-term results.
Implementation of uterine artery embolisation for symptomatic uterine fibroids: an inventory
The Netherlands journal of medicine, 2011
The validity of uterine artery embolisation (UAE ) as an alternative treatment for hysterectomy to treat symptomatic uterine fibroids has been well established. Despite its favourable outcomes, UAE is still only marginally applied in the Netherlands. The aim of this inventory is to identify factors which either restrict or facilitate the implementation of UAE. Gynaecologists and interventional-radiologists in three hospitals in Amsterdam were interviewed by means of questionnaires. One of these hospitals had ample experience in UAE for uterine fibroids, one hospital had just started providing this treatment, and one hospital did not perform UAE. Also patients with symptomatic fibroids who were scheduled for either UAE or hysterectomy were interviewed about the counselling for UAE. The following obstacles in the implementation of UAE were found: lack of knowledge about UAE , absence of a multidisciplinary protocol, and above all, the absence of UAE as one of the treatment options in ...
Uterine Artery Embolization of Symptomatic Uterine Fibroids: Success in Short Term Results
Scholars International Journal of Obstetrics and Gynecology
To evaluate the efficacy of uterine artery embolization (UAE) for the treatment of symptomatic uterine fibroids in patients treated at Al Ain Hospital, United Arab Emirates. Medical records and radiological images of all patients undergoing UAE in Al-Ain Hospital between 1 January 2012 and 31 December 2017 were retrospectively analysed. 141 patients aged 23-50 years were included in the study. Single femoral access technique was used in all patients. Clinical improvement was assessed by questioning patients regarding symptomatic improvement and follow up MRI to see the reduction in size of the dominant leiomyoma. Data was analyzed using SPSS 22. All 141 patients underwent technically successful UAE. 55 were lost follow up and were not included into the final analysis. Out of the remaining 85 patients, 55.3% were nulliparous and 44.7% were multiparous. A significant number of females that is 70.5% had multiple uterine fibroids compared to 30% who had only single uterine fibroid. 71.7% patients had menorrhagia pre-operatively, 98.4% had complete resolution at 6 months. As per the size reduction, paired t-Test showed statistically significant reduction in the mean leiomyoma size from 8 cm to 6cm and then further to 5 cm at 6 months and 1 year respectively. Almost 91.8% of the patients who underwent UAE were satisfied with the improvement in their symptoms as an outcome compared to 8.2% who were unsatisfied. Uterine fibroid embolization represents a promising method of treating fibroid-related menorrhagia and pelvic pain. Further studies with larger number of patients and long-term follow-up are needed.
Role of uterine artery embolisation in the treatment of symptomatic fibroids
International Journal of Advances in Medicine, 2017
Background: Uterine fibroids are the most common tumor in the female reproductive tract with high incidence of 40%. The objectives were to evaluate the technical success of the uterine artery embolisation in symptomatic fibroids and to evaluate improvement of symptoms and determine complications. Methods: Total 15 patients with symptomatic uterine fibroids were undergone uterine artery embolisation over a period of two years. The patients were followed with pelvic ultrasound immediately after the procedure and at 2 and 6 months intervals after procedure.Results: There was significant reduction in size of fibroids and improvement of symptoms after the procedure. Technical success rate and clinical success rate are 96% and 93% respectively which are comparable with other international studies. The complications with this procedure are few. The most common complication is pelvic pain.Conclusions: Uterine fibroids are the most common benign pelvic neoplasms, affecting nearly 40% of wo...