Evaluation of uterine artery embolization on myoma shrinkage: Results from a large cohort analysis (original) (raw)

Gynecology and Minimally Invasive Therapy

IntroductIon Uterine fibroids are the most common benign tumors in females with the incidence ranging from 20% to 25%. [1-3] The clinical manifestations of uterine fibroids mainly include menorrhagia and/or metrorrhagia which can lead to anemia, pain (dysmenorrhea, dyspareunia, and low back pain), issues with urinary function (frequency or obstruction), and constipation due to pressure on surrounding structures. [4,5] Uterine fibroids have also been associated with infertility even in asymptomatic women, [6] and their enlargement is dependent, at least in part, by hormonal influence. [7,8] Till date, surgery represents the gold standard treatments for several benign [9-11] and oncological [12-14] conditions. In this scenario, symptomatic uterine fibroids larger Objective: There are still contradictory opinions on the success rates of uterine artery embolization (UAE) for the treatment of myomas. In this scenario, our study aims to assess the effect of UAE on myoma shrinkage. Materials and Methods: The study included 337 women in reproductive age affected by a single symptomatic intramural myoma and declined surgery, undergoing UAE. The uterus and myoma diameters and volumes were determined on ultrasonographic scans before and 3, 6, and 12 months after the procedure. Results: The mean uterine volume before intervention was 226.46 ± 307.67 mm 3 , whereas myoma volume was 51.53 ± 65.53 mm 3. Further myoma progression was registered in only four patients. In remaining women, uterus volume in average decreased for 149.99 ± 156.63 mm 3 , whereas myomas decreased for 36.57 ± 47.96 mm 3. The mean volume reduction rate of the uterus was 49.54 ± 35.62 and for myoma was 57.58 ± 30.71. A significant decrease in both uterine and myoma volume was registered in every stage of the follow-up. The highest average decrease in uterine volume was in the first 3 months and myoma volume between 3 and 6 months following UAE. After 12 months follow-up, successful outcome (volume regression >50% respect to the baseline) was registered for uterus in 97.4% and for myoma in 67.9% of investigated patients. Conclusion: UAE was proven to allow a good success rate and can be considered as an effective alternative procedure for myoma treatment.