Fertility after uterine artery embolization of fibroids: a systematic review

Karlsen, Kamilla; Hróbjartsson, Asbjørn; Korsholm, Malene; Mogensen, Ole; Humaıdan, Peter; Ravn, Pernille

doi:10.1007/s00404-017-4566-7

Cited by 89 publications

(115 citation statements)

References 39 publications

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“…However, long standing study regarding outcomes of fertility in UAE is still limited. 17 Two cases in our study presented with secondary postpartum haemorrhage. Postpartum haemorrhage is one of the major cases of maternal mortality worldwide.…”

Section: Discussionmentioning

confidence: 66%

Uterine Artery Embolization: Different Indications and Outcome

Mukherjee¹,

Bhattacharyya²,

Chakrabarty³

et al. 2019

jebmh

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BACKGROUNDUterine Artery Embolization is an Interventional Radiology technique involving placement of a catheter and injection of an embolizing agent in the uterine artery. It has now become an accepted option for the treatment of symptomatic fibroids and other gynaecological conditions. This study seeks to report the different indications and outcomes of uterine artery embolization for variety of gynaecological and obstetrical conditions. METHODS 30 women who presented for uterine artery embolization in a tertiary care teaching hospital in eastern India from June 2016 to May 2017 were retrospectively studied with follow-up up to 12 months for indications, success rate and complications. RESULTSTechnical success rate was achieved in 96.67% of cases. The most common indication for embolization was uterine fibroids. Mean reduction of fibroid volume was 51.7% at 6 weeks, 67.9% at 6 months. Most common complaint following embolization was pelvic pain, which could be managed conservatively. CONCLUSIONSUterine artery embolization is a safe and effective minimally invasive technique which can be used to manage different obstetrical and gynaecological conditions with high technical success rate and minimal complications. It is also a minimally invasive, uterus sparing treatment option in patients willing to preserve their fertility. HOW TO CITE THIS ARTICLE: MukherjeeA, Bhattacharyya B, Chakrabarty R, et al. Uterine artery embolization: different indications and outcome.

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Section: Discussionmentioning

confidence: 66%

Uterine Artery Embolization: Different Indications and Outcome

Mukherjee¹,

Bhattacharyya²,

Chakrabarty³

et al. 2019

jebmh

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“…However, 35% of patients need secondary hysterectomy after UAE [41] . Furthermore, the pregnancy rate was found to be lower and miscarriage rate higher after UAE than after myomectomy [42] .…”

Section: Discussionmentioning

confidence: 91%

Single-port laparoscopic myomectomy in the virgin womb - a retrospective analysis of 31 consecutive cases

Tang¹

2020

MIS

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How to cite this article: Tang FH. Single-port laparoscopic myomectomy in the virgin womb -a retrospective analysis of 31 consecutive cases. Mini-invasive Surg 2020;4:24. http://dx. AbstractAim: We aimed to evaluate the feasibility of single-port laparoscopic myomectomy in the virgin womb. Methods:A retrospective chart review of 31 consecutive cases between November 2017 and October 2019 performed by a single surgeon was performed. Results:The mean age of patient was 50.10 ± 7.79 years old. The mean BMI was 23.55 ± 4.36 kg/m 2 . The mean number of myoma in single patient was 3.84 ± 2.45 pieces. The mean maximum diameter of myoma in single patient was 11.24 ± 3.27 cm. The mean operation time was 182.32 ± 52.39 min. The mean blood loss was 231.77 ± 238.90 mL. The Visual Analogue Score (VAS) of pain when immediately arriving at the ward after operation was 2.32 ± 1.60. The VAS after 24 h dropped to 1.23 ± 1.43. In total, 119 myomas were removed in our study. There were 15 (48.4%) women with more than four myomas. Fifteen (48.4%) women had more than two myomas that were > 5 cm. There were 58 (48.74%) intramural myomas, with mean diameter of 6.72 ± 4.41 cm. Fifty-two (43.70%) subserous type myoma were removed with mean diameter 2.58 ± 3.35 cm. Posterior myoma accounted for five (4.20%) pieces with mean diameter of 9.30 ± 4.49 cm. The broad ligament type myoma accounted for four pieces (3.36%), and the mean diameter was 3.74 ± 1.87 cm. There were 51 (42.9%) myomas > 5 cm in diameter. Among the different types of myoma, there were 36 (62.1%) intramural type and 6 (11.5%) subserous type, and all posterior and broad ligament type were > 5 cm in diameter. The blood loss and operation time showed no relationship to myoma number. There were differences in blood loss (P = 0.0359) and operation time (P = 0.0537) based on the maximum diameter of myoma. No learning curve was noted in the cumulative sum control chart analysis of the 31 consecutive cases. Conclusion:In our 31 consecutive cases, the operation time, blood loss, and postoperative VAS score were all comparable to the previously published literature for single-port laparoscopic myomectomy. It is feasible for virgin women with symptomatic myoma to receive single-port laparoscopic myomectomy.

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“…UAE is an effective treatment for post‐partum hemorrhage . However, there are concerns that the technique of UAE for RPOC has not been established, and UAE may affect ovarian dysfunction and infertility . In our study, UAE was used because of the large amount of continuous bleeding and severe vascularity in 34 (59.6%) patients.…”

Section: Discussionmentioning

confidence: 93%

“…13,14 However, there are concerns that the technique of UAE for RPOC has not been established, and UAE may affect ovarian dysfunction and infertility. [15][16][17][18][19] In our study, UAE was used because of the large amount of continuous bleeding and severe vascularity in 34 (59.6%) patients. For this reason, patients in the UAE group were more likely have intrauterine vascular lesions at diagnosis ( Table 2).…”

Section: Discussionmentioning

confidence: 98%

Complications and reproductive outcome after uterine artery embolization for retained products of conception

Ohmaru-Nakanishi

Kuramoto

Maehara

et al. 2019

J of Obstet and Gynaecol

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Aim The purpose of this study was to evaluate the complications and reproductive outcome after uterine artery embolization (UAE) for retained products of conception (RPOC). Methods This was a retrospective medical‐records review study of 57 women treated for RPOC. Participants were divided into two groups: women who underwent treatment with UAE (UAE group: n = 32, 56.1%) and those without UAE (control group: n = 25, 43.9%). The complications and reproductive outcomes were compared between the two groups. Information on subsequent pregnancies and their outcomes was available for 30 women who attempted to conceive. Results There were no significant differences in the interval from the last delivery or abortion (40.1 ± 3.4 vs 51.0 ± 5.1 months, respectively; P = 0.16), the rate of severe bleeding under hysteroscopy (18.5 vs 9.1%, respectively; P = 0.65), the conception rate (58.8 vs 61.5%, respectively; P = 1.0) and mean time to conception (9.9 ± 1.6 vs 11.0 ± 2.9 months, respectively; P = 0.17) in women in the UAE group compared with those in the control group. Rates of post‐partum hemorrhage (PPH) and manual removal of placenta (25.0% in the UAE group and 16.7% in the control group, respectively) were higher than the general population. Conclusion Selective UAE for RPOC may be a preferable procedure in women who are suspected as having a risk of severe bleeding under treatment. Women who were treated for RPOC, regardless of UAE, were at risk of PPH and difficulty in removing the placenta in future pregnancies.

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Fertility after uterine artery embolization of fibroids: a systematic review

Cited by 89 publications

References 39 publications

Uterine Artery Embolization: Different Indications and Outcome

Uterine Artery Embolization: Different Indications and Outcome

Single-port laparoscopic myomectomy in the virgin womb - a retrospective analysis of 31 consecutive cases

Complications and reproductive outcome after uterine artery embolization for retained products of conception

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