Uterine artery embolisation for the treatment of symptomatic fibroids in 114 women: reduction in size of the fibroids and women's views of the success of the treatment

Abstract

Objective To assess the reduction in size of fibroids following uterine artery embolisation and to analyse women's views of the success of treatment. Design An uncontrolled case series of 114 consecutive women who underwent uterine artery embolisation for the treatment of fibroids over two years. Setting The Diagnostic and Interventional Radiology Department at The Royal Surrey County Hospital, Guildford, UK. Methods Bilateral uterine artery embolisation was performed for the treatment of symptomatic fibroids.Magnetic resonance imaging was carried out before and six months following embolisation. Women completed outcome questionnaires following their treatment. Main outcome measures The sites, imaging signal characteristics and percentage reduction in the volume of three dominant fibroids were determined from the magnetic resonance scans. Outcome was measured by questionnaire. Women were asked whether their symptoms resolved completely, improved, remained unchanged or deteriorated. Results One hundred and sixty-five fibroids of 114 women (mean age 42) were analysed. Forty-five percent of women had complex fibroid masses and 50% had fibroids ! 8.5cm in diameter. The median reduction in the fibroid volume was 58%. The median reduction of the volume of complex fibroid masses, submucous fibroids, fibroids ! 8.5cm and fibroids with high and low signal on T2 weighted sequences were 58%, 63%, 50%, 62% and 51%, respectively. Ninety-one percent of the women's symptoms had resolved or improved following embolisation. Discussion The majority of women were satisfied with their outcome. We have shown that uterine artery embolisation is a successful treatment for symptomatic fibroids of all types, sizes and signal characteristics.

Long‐term follow up of uterine artery embolisation—an effective alternative in the treatment of fibroids

“…We have previously published a series of procedures, with a median follow up of 16.7 months, demonstrating that in most cases, the uterus shrank by an average of 67%, 6 paralleling the symptomatic improvement seen. We have also shown that fibroid embolisation was effective for subserous, interstitial and submucous fibroids, irrespective of size or number of fibroids present 7 . The major advantage of fibroid embolisation over other procedures is that it has the potential to affect all fibroids at one procedure, compared with myomectomy for cases of multiple fibroids, where it is difficult to remove every fibroid 8 .…”

Uterine artery embolisation for symptomatic fibroids: the effect of the large uterus on outcome

“…There are also concerns about the effectiveness of UAE in large uteri exceeding 24 weeks and generally use of UAE as a treatment option in these women is not advised. The diameter of the largest fibroid >8.5 cm has also been found to predict UAE failure, but was not confirmed in other studies 5 . Therefore, the effect of a large uterus on symptomatic outcome was investigated.…”

Laparoscopic blockage of uterine artery and myomectomy

“…With this form of treatment, based on the hypothesis that control of arterial blood flow will control symptoms, dominant myomas are reduced by 39%-70%, and most patients experience relief of their myoma-related symptoms [23]. Interestingly, regrowth of the treated myomas occurred in only 3.5% of the cases treated in this way.…”