Long‐term durability of uterine artery embolisation for treatment of symptomatic adenomyosis

Ma, Jolande; Brown, Bevan; Liang, Eisen

doi:10.1111/ajo.13304

Cited by 17 publications

(19 citation statements)

References 31 publications

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“…Uterine artery embolization (UAE) has been proposed as a less invasive alternative to hysterectomy to treat adenomyosis. During this angiographic procedure, an embolic agent is injected into the uterine arteries to induce ischaemic infarction of adenomyotic foci [ 101 , 102 ]. In an extensive review by de Bruyn et al [ 101 ], it was showed that UAE improves clinical symptoms in 83% of patients, but great JZ thickness is associated with decreased effectiveness.…”

Section: Non-surgical Alternativesmentioning

confidence: 99%

“…In a more recent study [ 102 ], women having undergone UAE for adenomyosis were contacted via SMS, email, or phone calls and invited to participate in the follow-up study on a voluntary basis. Improvement of symptoms was indeed observed in 80% of patients responding to the survey, but it should be stressed that recall bias may limit the accuracy of these findings.…”

Section: Non-surgical Alternativesmentioning

confidence: 99%

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Conservative Management of Uterine Adenomyosis: Medical vs. Surgical Approach

Stratopoulou

Donnez

Dolmans

2021

JCM

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Uterine adenomyosis is a commonly encountered estrogen-dependent disease in reproductive-age women, causing heavy menstrual bleeding, intense pelvic pain, and infertility. Although adenomyosis was previously considered a disease of multiparous women, it is becoming increasingly evident that it also affects younger nulliparous women and may compromise their fertility potential. It is clear that hysterectomy, the standard approach to definitively manage the disease, is not an option for patients wishing to preserve their fertility, so there is an urgent need to develop novel conservative strategies. We searched the current literature for available methods for conservative management of adenomyosis, including both pharmacological and surgical approaches. There is no existing drug that can cure adenomyosis at present, but some off-label treatment options may be used to tackle disease symptoms and improve fertility outcomes. Adenomyosis in patients wishing to conceive can be ‘treated’ by conservative surgery, though these procedures require highly experienced surgeons and pose a considerable risk of uterine rupture during subsequent pregnancies. While currently available options for conservative management of adenomyosis do have some capacity for alleviating symptoms and enhancing patient fertility perspectives, more effective new options are needed, with gonadotropin-releasing hormone antagonists showing encouraging results in preliminary studies.

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Section: Non-surgical Alternativesmentioning

confidence: 99%

Section: Non-surgical Alternativesmentioning

confidence: 99%

Conservative Management of Uterine Adenomyosis: Medical vs. Surgical Approach

Stratopoulou

Donnez

Dolmans

2021

JCM

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“…As one of the direct clinical outcome assessments [ 11 ], patient-reported outcome (PRO)-based symptom and QoL measures serve as reliable approaches for patients with UFs throughout the full course of diagnosis [ 12 ], treatment [ 13 ], and disease management [ 14 ]. Consequently, measuring UF-related symptoms and QoL status in a valid and reliable manner could support high-quality practice and comprehensive patient management for patients of diverse cultures.…”

Section: Introductionmentioning

confidence: 99%

Adaptability and clinical applicability of UFS-QoL in Chinese women with uterine fibroid

Chen

et al. 2022

BMC Women's Health

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Objective To demonstrate the applicability and adaptability of uterine fibroid symptoms and quality of life (UFS-QoL) in assessing the efficacy of treatment in Chinese populations. Methods This is a secondary analysis of a prospective cohort study involving 20 Chinese hospitals and 2,411 Chinese women with fibroids. Patients completed UFS-QoL and short form-36 (SF-36) at pre-surgery, 6-month and 12-month post-treatments. Internal consistency of the quality of life assessed by the UFS-QoL questionnaire using Cronbach’s α coefficient (α). Principal axis factor analysis with orthogonal rotation was established to investigate relationships between items and subscales. Concurrent validity refers to the Spearman's correlation estimate of the correlation between UFS-QoL and SF-36. Using effect size and standardized response mean, the ability to detect change was evaluated by comparing pre- and post-6-month and post-12-month treatment scores. Results Exploratory factor analysis yielded six subscales (concern, activities, energy/mood, control, self-consciousness, and sexual function) with eigenvalues > 1 in UFS-QoL. A 63.61% total variance was explained by the test items. Ceiling effects of self-consciousness and sexual functioning subscales from UFS-QoL were > 15%. UFS-QoL showed a positive and moderate correlation with SF-36 to establish good concurrent validity. And showed good consistency reliability (Cronbach α > 0.7 in all subscales), ability to detect change after treatment. This excluded self-consciousness (α = 0.56), which demonstrated the lowest effect size (0.38) and standardized response means (0.38) 6- and 12-months post-treatment. Conclusions Symptom severity, activity, and mood subscales of the Chinese UFS-QoL were valid and reliable. However, the self-consciousness domain needs further investigation on cultural adaptation, such as cognitive debriefing for how Chinese interpret these questions.

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“…Uterine artery embolisation (UAE) is an established treatment option for symptomatic uterine fibroids in all locations [1][2][3][4][5][6][7][8][9][10] and has shown early success in adenomyosis [11,12]. UAE offers several advantages in comparison to surgical options (myomectomy or hysterectomy), including shorter average length of hospital stay, shorter recovery period, similar rates of symptomatic improvement, retention of the uterus, and no requirement for general anaesthesia [1][2][3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Current Strategies for Prevention of Infection After Uterine Artery Embolisation

Lukies

Clements

2022

Cardiovasc Intervent Radiol

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Uterine artery embolisation (UAE) is a safe and effective procedure for symptomatic uterine fibroids with an estimated rate of post-operative intra-uterine infection of 0.9–2.5%. While rates of infection have remained low over the past two decades, there is variation in infection prevention practices. Intra-uterine infection after UAE may occur via access site haematogenous spread or ascension of vaginal flora through the cervical canal. Although the evidence base is immature, risk factors for infection including previous pelvic infection, hydrosalpinx, endocervical incompetence, diabetes, smoking, obesity, respiratory disease, and immunosuppression should be assessed during the pre-operative consultation with the interventional radiologist to tailor a plan for minimising infection, which may include optimisation of any modifiable risk facts and prophylactic antibiotics.

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Long‐term durability of uterine artery embolisation for treatment of symptomatic adenomyosis

Cited by 17 publications

References 31 publications

Conservative Management of Uterine Adenomyosis: Medical vs. Surgical Approach

Conservative Management of Uterine Adenomyosis: Medical vs. Surgical Approach

Adaptability and clinical applicability of UFS-QoL in Chinese women with uterine fibroid

Current Strategies for Prevention of Infection After Uterine Artery Embolisation

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