Uterine artery embolization for the treatment of fibroids.

Issues in emerging health technologies 09/2002; DOI: 10.1016/S0015-0282(02)04683-6
Source: PubMed

ABSTRACT Uterine artery embolization (UAE), or uterine fibroid embolization, is a non-surgical treatment for uterine fibroids that preserves the uterus and offers women an alternative to surgical procedures such as hysterectomy and myomectomy. Evidence from controlled trials comparing fibroid treatments is not yet available. Case series reports indicate that UAE is a relatively safe and effective treatment for symptomatic fibroids. The effect of UAE on fertility and pregnancy is not known, though pregnancies following UAE have been reported. UAE may reduce health care costs associated with treating fibroids through shorter hospital stays and faster recoveries.

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    ABSTRACT: Objective. To evaluate ovarian function in 29 patients who underwent uterine artery embolisation (UAE). Methods. Twenty-nine patients with myomas of the uterus underwent UAE using polyvinyl alcohol (PVA) particles with a diameter of 150 - 550 µm. Follicle-stimulating hormone (FSH) levels were measured before and after UAE. Results. The median age of the patients was 39 years (range 19 - 51 years). Two patients (7%) were menopausal before UAE was attempted. In 3 patients (10.3%), normal pre-procedural FSH values rose to menopausal levels afterwards (95% confidence interval (CI) 3.6 - 26.4%). Only 1 of these patients was younger than 40 years of age (39 years). Of 15 patients less than 40 years of age, 6.7% (95% CI 1.2 - 29.8%) therefore developed a significant rise in FSH levels. One patient, aged 35 years, developed temporary amenorrhoea and endometrial atrophy, which returned to normal within a year. Conclusions. UAE resulted in ovarian failure in 7% of patients younger than 40 years of age and 10% of patients overall.
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    ABSTRACT: Objective. – To evaluate the effectivenesss of the uterine artery embolization as the treatment of symptomatic uterine leiomyomata.Patients and methods. – Eighty-five women with symptoms caused by uterine leiomyomata underwent uterine artery embolization as an alternative to surgery from january 1997 to june 2000. The effectiveness of this method was evaluated by clinical and sonographic examination.Results. – The recession average was of 18.9 months. There were ten failures. We had immediate failures (n = 5) with a case of technical failure, one endometrium cancer, one adenomyosis, one larger subserosal leiomyomata and one parametrial leiomyomata. We had recurrences (n = 5) with the occurrence of new leiomyomatas (1 intramural and 3 submucosal) and an evolution of previous leiomyomata. The average volume reduction was 51% for the uterus and 65% for the main fibroid at one year follow-up. Minor complications occurred in 5%. Permanent amenorrhoea was observed for 3.75% of the women. Using cox model, no predictive factors of embolisation effectiveness were found.Discussion and conclusion. – In the treatment of symptomatic uterine leiomyoma, uterine artery embolization is an effective alternative to surgery. After one year and half, we had 12.5% of failures.
    Gynécologie Obstétrique & Fertilité 02/2003; 31(2):117-122. DOI:10.1016/S1297-9589(03)00004-3 · 0.58 Impact Factor