Embolization of uterine fibroids (original) (raw)
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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 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.
Uterine artery embolization for the treatment of uterine fibroids
PubMed, 2004
Uterine artery embolization can be regarded as a less invasive procedure for the treatment of fibroids compared with myomectomy, hysterectomy, and laparoscopic myolysis. The aim of this study was the evaluation of safety and efficacy of uterine artery embolization and of womens' opinion about this treatment. After gynecological examination sixty-nine premenopausal women underwent uterine artery embolization. All procedures but four were technically successful; three women underwent unilateral embolization because of vascular malformation and one of them had an allergic reaction to contrast medium. Of the 69 patients: 58 went home the day after embolization, and 11 within first week. The follow-up examinations after 3, 6 and 12 month showed a significant reduction of uterine and fibroid volume with significant improvement of bleeding. Therefore, according to this report, uterine artery embolization is a successful, minimal invasive treatment of myoma that preserves the uterus and requires shorter hospitalization and recovery times than surgery.
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.
Uterine fibroids embolization in a tertiary hospital: our initial experience
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2015
Background: Uterine Fibroid Embolization (UFE) is a new modality which has appeared in the horizon for nonsurgical management of many conditions including fibroids. Moderate to severe anemia with fibroids is one of the reasons for delay in definitive treatment. Need for blood transfusion and its consequent risk of adverse reactions and diseases became a necessity to consider alternative treatment. Objective: To evaluate the efficacy and safety of UFE as an alternative to major surgery. Methods: Seventeen women with symptomatic uterine fibroids who declined surgery or were at poor risk for surgery were treated by Uterine Artery Embolization (UAE). The uterine arteries were catheterised and embolized with polyvinyl alcohol particles. The patients were followed up at regular interval clinically and with transabdominal ultrasonography. Results: UAE performed on all 17 patients had no major complications. Clinical follow-up showed a significant reduction in symptoms within six months of the procedure, with 79% improvement in menorrhagia and 86% improvement in pain. Follow-up imaging showed reduction in fibroid sizes ranging from 9-60%. The mean procedural time was 150 minutes. The mean hospital stay was 5 days (range, 3 to 10). Conclusions: Mid-term results of UAE for the treatment of symptomatic fibroids in our hospital indicate this to be a safe and effective therapeutic option.
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...
Uterine Artery Embolization for Treatment of Symptomatic Fibroids: A Review of the Evidence
Iranian Red Crescent Medical Journal, 2013
Fibroids are the most common benign tumors of the uterus during female reproductive age. Uterine artery embolization (UAE) using embolic particles (PVA, Gelfoam) to occlude the uterine arteries, have been reported as a relatively safe, effective, and durable nonsurgical alternative to hysterectomy in diminishing fibroidrelated symptoms. To block the arterial blood supply to the fibroid completely, UAE is typically performed in both uterine arteries by an experienced interventional radiologist. Reduction in menorrhagia has been reported as 80-93 percent and the mean decrease in fibroid size varies from 50-78% in the literature. In our center improvement in menstrual bleeding after 6 months was 80.3%, and uterine fibroids underwent shrinkage of 63.7±33.7% after12 months. Complication rate including amenorrhea ranges from 1% -7% in the literature. UAE may be followed by menopause in 1% of cases. Nevertheless, it is usually encountered in women in their late 40s. It seems that the future of UAE depends on optimal selection of patients according to volume-shrinkage prediction and fertility outcome. Although pregnancy is possible after embolization, however neither fertility preservation nor improvement can be guaranteed following UAE. Indeed, Women who desire to become pregnant should be cautioned about potential complications during pregnancy. The aim of this review is to discuss about the efficacy, safety, technique, and choice of embolic agent. Also we present the effects of this technique on fertility and pregnancy outcome and also methods for dose reduction during this procedure.
CardioVascular and Interventional Radiology, 2008
The purpose of this study was to evaluate whether the size, location, or number of fibroids affects therapeutic efficacy or complications of uterine artery embolization (UAE). Patients with symptomatic uterine fibroids (n = 101) were treated by selective bilateral UAE using 500-to 710-lm polyvinyl alcohol (PVA) particles. Baseline measures of clinical symptoms, sonography, and MRI taken before the procedure were compared to those taken 1, 3, 6, and 12 months later. Complications and outcomes were analyzed for associations with fibroid size, location, and number. Reductions in mean fibroid volume were similar in patients with single (66.6 ± 21.5%) and multiple (67.4 ± 25.0%) fibroids (p-value = 0.83). Menstrual improvement occurred in patients with single (93.3%) and multiple (72.2%) fibroids (p = 0.18). Changes in submucosal and other fibroids were not significantly different between the two groups (p's [ 0.56). Linear regression analysis between primary fibroid volume as independent variable and percentage reduction of fibroid volume after 1 year yielded an R 2 of 0.083 and the model coefficient was not statistically significant (p = 0.072). Multivariate regression models revealed no statistically or clinically significant coefficients or odds ratios for three independent variables (primary fibroid size, total number, and fibroid location) and all outcome variables (percent reduction of uterus and fibroid volumes in 1 year, improvement of clinical symptoms [menstrual, bulk related, and urinary] in 1 year, and complications after UAE).
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...