The Ontario Uterine Fibroid Embolization Trial. Part 2. Uterine fibroid reduction and symptom relief after uterine artery embolization for fibroids

Pron, Gaylene; Bennett, John D.C.; Common, Andrew; Wall, Jane; Asch, Murray; Sniderman, Kenneth W.

doi:10.1016/s0015-0282(02)04538-7

Cited by 360 publications

(197 citation statements)

References 33 publications

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“…Transient or permanent amenorrhea and other symptoms of ovarian failure have been found in more than 5% of women who have undergone UAE, especially women older than 45 years [34][35][36]. However, there have been reports of ovarian failure in younger women [35,37].…”

Section: Discussionmentioning

confidence: 99%

Pregnancy After Uterine Artery Embolization for Symptomatic Fibroids: A Series of 15 Pregnancies

Firouznia

Ghanaati

Sanaati³

et al. 2009

American Journal of Roentgenology

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[12,13], and cervical ectopic pregnancy [14][15][16] has been reported.The effects of embolization on ovarian function are important when preservation of fertility is desired. Few articles have focused on the effect of UAE for fibroids and its outcome on future fertility and pregnancy. To the best of our knowledge, pregnancy after UAE has been described in the literature in the form of case reports [17][18][19][20], a review article [21], and retrospective reports of case series [22][23][24][25][26][27][28][29]. As of March 2008, more than 170 patients worldwide had become pregnant after UAE. At a university-affiliated referral hospital in Iran, we evaluated the pregnancies of women who underwent UAE for symptomatic fibroids and desired to become pregnant. Subjects and Methods From Wo m e n's I m ag i ng • O r ig i n a l R e s e a rc h Uterine fibroids are among the most common benign tumors of the female pelvis that cause abnormal menstrual bleeding. Uterine artery embolization (UAE) in the management of uterine myomas was first reported by Ravina et al. in 1995 [1]. Their promising results were confirmed in several uncontrolled cohort studies, which showed an approximately 50% decrease in uterine volume and relief of symptoms in 80-90% of patients [2]. The advantages of UAE include lower cost and more rapid recovery than can be achieved with conventional therapies [3][4][5]. The efficacy of uterine embolization in the management of pelvic hemorrhage has been well documented in obstetrics and gynecology [6][7][8]. Successful pregnancy outcome after embolization for obstetric hemorrhage [9,10] Please see the commentary on this article, which appears on the following pages. W O M E N ' S I M A G I N G PROOF Copyrighted Material For Review Only • Not for DistributionPage Copy OBJECTIVE. The purpose of this study was to report on pregnancies and their outcome after uterine artery embolization for uterine fibroids. SUBJECTS AND METHODS. From 2001 to 2004, 102 patients (mean age, [± SD]35.7 ± 6.4 years; range, 20-48 years) with symptomatic uterine fibroids underwent uterine artery embolization with 500-to 710-µm polyvinyl alcohol particles. The mean uterine volume was 552 ± 649 cm 3 (range, 94-4,656 cm 3 ), and the dominant fibroid size was 228 ± 359 cm 3 (range, 14-2,618 cm 3 ) before the procedure. During the 2-year follow-up period, the patients were asked whether they were trying to achieve pregnancy and whether they were successful. We obtained pregnancy and obstetric records of the pregnant women from physicians' offices and hospitals.RESULTS. Among 102 women who underwent bilateral uterine artery embolization, 23 (22.5%) were seeking to become pregnant, and 14 of the 23 (61%) became pregnant, nine having been nulliparous. One patient had two pregnancies. Fourteen pregnancies were spontaneous, and one was achieved by zygote intrafallopian transfer. Two miscarriages occurred, one in the 12th and one in the 16th week of gestation. The other 13 pregnancies went to term, were uncomplicated, and ended in elective...

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Section: Discussionmentioning

confidence: 99%

Pregnancy After Uterine Artery Embolization for Symptomatic Fibroids: A Series of 15 Pregnancies

Firouznia

Ghanaati

Sanaati³

et al. 2009

American Journal of Roentgenology

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“…Pron et al reported results of 550 patients from the Ontario Uterine Fibroid Embolization Trial [31,32]. In this study menorrhagia improved in 83%, menstrual pain improved in 77% [33].…”

Section: Discussionmentioning

confidence: 87%

Our Clinical Experience on Uterine Artery Embolization for the Treatment of Uterine Fibroids: A Retrospective Case-Series of 32 Patients

Yildiz¹

2017

OMICS J Radiol

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“…Another study reported that 40 of 51 patients (78%) who underwent UAE had their menorrhagia improved; dysmenorrhea was improved in 24 (47%) and pelvic pain in 20 (39%). 34 In another series of 30 patients with myomectomy, 25 (83%) had improvement in menorrhagia, 19 (63%) in dysmenorrhea, and 19 (63%) in pelvic pain. 22 A case series evaluating 395 women after UAE for symptomatic fibroids observed improvement in menstrual bleeding and pelvic pain in 84% and 79%, respectively, after 16 months.…”

Section: Discussionmentioning

confidence: 94%

Midterm Outcome of Ultrasound-Guided Alcohol Gel Sclerotherapy for Symptomatic Leiomyoma

Pessoa

Gurgel

Ávila

et al. 2010

Journal of Ultrasound in Medicine

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AbbreviationsGnRH, gonadotropin-releasing hormone; UAE, uterine artery embolization eiomyoma, also known as a fibromyoma or fibroid, is a frequent gynecologic disorder affecting approximately 25% to 35% of women, especially black women, at some point in their lives. 1Although most patients are asymptomatic, the fact that about 50% have clinical symptoms explains the high number of hysterectomies performed all over the world (538,722 per year for benign disease in the United States in 2003).2 The main symptoms of leiomyoma include heavy menstrual bleeding, pelvic pain, abdominal swelling, intestinal, urinary, or venous pressure, and hemorrhagic vaginal discharge (bleeding between periods).3 In addition, myomas are considered infertility factors, although the mechanisms of this association have not been clarified. 4 Diagnosis has been facilitated in the past few years by dissemination of ultrasound techniques. The sensitivity and specificity of ultrasound for diagnosing leiomyomas are as high as 99% and 91%, respectively. L ArticleObjective. The purpose of this study was to describe the outcome of ultrasound-guided ethanol gel sclerotherapy of myomatous nodules 1 to 18 months after treatment. Methods. A total of 118 consecutive patients with a diagnosis of symptomatic leiomyomas referred for ethanol gel sclerotherapy were studied between November 2005 and July 2007. Clinical (self-administered symptom questionnaire) and ultrasound follow-ups were done 1 to 2, 6 to 8, and 12 to 18 months after the procedure. Results. The mean baseline volumes ± SD were 223.3 ± 158.3 cm 3 for the uterus and 68.4 ± 110.5 cm 3 for the dominant fibroid. The most common adverse reaction in the immediate postoperative period was pelvic pain in 27.1% of the patients, but 58.4% had no reactions. After 12 months, a 29.5% reduction in uterine volume was observed in 64.7% of the patients. A 55.5% reduction in dominant fibroid volume was observed in 82.8% of the patients. Pelvic pain improved in 29.8% of the sample, dysmenorrhea in 51.7%, and menstrual flow in 39%. Most patients (77%) reported being satisfied or very satisfied with the treatment. Conclusions. The results suggest that ethanol gel sclerotherapy is a safe, conservative alternative for treating symptomatic uterine leiomyomas. Further randomized studies are necessary to determine the suitability and indications of this procedure in comparison to other minimally invasive techniques.

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The Ontario Uterine Fibroid Embolization Trial. Part 2. Uterine fibroid reduction and symptom relief after uterine artery embolization for fibroids

Cited by 360 publications

References 33 publications

Pregnancy After Uterine Artery Embolization for Symptomatic Fibroids: A Series of 15 Pregnancies

Pregnancy After Uterine Artery Embolization for Symptomatic Fibroids: A Series of 15 Pregnancies

Our Clinical Experience on Uterine Artery Embolization for the Treatment of Uterine Fibroids: A Retrospective Case-Series of 32 Patients

Midterm Outcome of Ultrasound-Guided Alcohol Gel Sclerotherapy for Symptomatic Leiomyoma

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