Efficacy of uterine artery embolisation for treatment of symptomatic fibroids and adenomyosis – An interim report on an Australian experience

Eisen Liang, Bevan Brown, Rodney Kirsop, Paul Stewart, P. Stewart, Andrew Stuart
The Australian & New Zealand journal of obstetrics & gynaecology · 2012 · vol. 52(2) , pp. 106–112 · doi:10.1111/j.1479-828x.2011.01399.x · PMID:22221154 · W2156680878
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This Australian audit found uterine artery embolisation to be a safe and highly effective treatment for symptomatic fibroids and adenomyosis, with high rates of symptom improvement and significant volume reductions.

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Abstract

BACKGROUND: Uterine artery embolisation (UAE) has been widely described internationally, however there is a paucity of data reported from Australia. AIM: To conduct a local audit on the efficacy and safety of UAE treating symptomatic fibroids and adenomyosis. METHODS: Clinical data of 76 consecutive UAEs were reviewed. Degree of fibroid-related symptoms before embolisation and at follow-up visits were compared. Procedural and subsequent complications were recorded. Uterine and fibroid volumes were measured on MRI at baseline and six months post-UAE. RESULTS: Seventy-six UAEs were performed in 75 women. Fifty-nine women had follow-up duration of more than six months, and one woman was lost to follow-up. Clinical success was 93% overall (n = 59) and 96% for menorrhagia (n = 49). For dysmenorrhoea (n = 36), 89% of women had at least some improvement, 75% had significant improvement and 56% had resolution of pain. For urinary symptoms (n = 32), 97% of women had at least some improvement and 50% had resolution of all urinary symptoms. Adenomyosis was found in 17 (29%) women treated. The primary success rate was 96%, and secondary success rate (after repeat UAE) was 100%. MRI showed 50% uterine volume reduction and 60% dominant fibroid volume reduction. There were no significant procedural-related acute complications. There were three possible cases of endometritis, two managed conservatively and one required hysterectomy. CONCLUSIONS: This audit, based on local Australian experience, has confirmed that UAE is a safe and highly effective treatment for women with symptomatic fibroids and/or adenomyosis.

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Condition tags

mesh:D004412mesh:D004715adenomyosisdysmenorrhea

MeSH descriptors

Endometriosis Leiomyoma Uterine Artery Embolization Adult Australia Clinical Audit Dysmenorrhea Dysmenorrhea Endometriosis Female Follow-Up Studies Humans Leiomyoma Lost to Follow-Up Menorrhagia Menorrhagia Middle Aged Organ Size Treatment Outcome Uterus

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