Uterine Artery Embolization for the Treatment of Symptomatic Uterine Fibroids of Different Sizes: A Single Center Experience

Cappelli, Alberta; Mosconi, Cristina; Cocozza, Maria Adriana; Brandi, Nicolò; Bartalena, Laura; Modestino, Francesco; Galaverni, Maria Cristina; Vara, Giulio; Paccapelo, Alexandro; Pizzoli, Gloria; Villa, Gioia; Seracchioli, Renato; Renzulli, Matteo

doi:10.3390/jpm13060906

Cited by 4 publications

(1 citation statement)

References 80 publications

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“…As the uterus receives accessory blood flow, normal uterine tissue heals from the ischemic shock. In contrast, fibroids are unambiguously damaged, which results in ischemic damage with necrosis and finally an irreparable reduction in fibroid size [ 43 , 44 ].…”

Section: Resultsmentioning

confidence: 99%

Currently Available Treatment Modalities for Uterine Fibroids

Micić,

Macura,

Andjić

et al. 2024

Medicina

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Uterine fibroids (leiomyomas and myomas) are the most common benign gynecological condition in patients presenting with abnormal uterine bleeding, pelvic masses causing pressure or pain, infertility and obstetric complications. Almost a third of women with fibroids need treatment due to symptoms. Objectives: In this review we present all currently available treatment modalities for uterine fibroids. Methods: An extensive search for the available data regarding surgical, medical and other treatment options for uterine fibroids was conducted. Review: Nowadays, treatment for fibroids is intended to control symptoms while preserving future fertility. The choice of treatment depends on the patient’s age and fertility and the number, size and location of the fibroids. Current management strategies mainly involve surgical interventions (hysterectomy and myomectomy hysteroscopy, laparoscopy or laparotomy). Other surgical and non-surgical minimally invasive techniques include interventions performed under radiologic or ultrasound guidance (uterine artery embolization and occlusion, myolysis, magnetic resonance-guided focused ultrasound surgery, radiofrequency ablation of fibroids and endometrial ablation). Medical treatment options for fibroids are still restricted and available medications (progestogens, combined oral contraceptives andgonadotropin-releasing hormone agonists and antagonists) are generally used for short-term treatment of fibroid-induced bleeding. Recently, it was shown that SPRMs could be administered intermittently long-term with good results on bleeding and fibroid size reduction. Novel medical treatments are still under investigation but with promising results. Conclusions: Treatment of fibroids must be individualized based on the presence and severity of symptoms and the patient’s desire for definitive treatment or fertility preservation.

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Section: Resultsmentioning

confidence: 99%

Currently Available Treatment Modalities for Uterine Fibroids

Micić,

Macura,

Andjić

et al. 2024

Medicina

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Risk factors affecting long-term efficacy of ultrasound-guided high-intensity focused ultrasound treatment for multiple uterine fibroids

Lin,

Xu,

Yuan

et al. 2024

International Journal of Hyperthermia

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Uterine artery embolization in the treatment of uterine fibroids and the preservation of reproductive health in women 40 years of age and older: A retrospective study

Solovyeva,

Chegus,

Aleynikova

et al. 2024

Gynecology

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Aim. To evaluate the effect of uterine artery embolization (UAE) on reproductive health in women 40 years and older. Materials and methods. A retrospective study was conducted at the perinatal center of the District Clinical Hospital of Khanty-Mansiysk. Patients were divided into two groups: the main group (group 1; n=57) included women with uterine fibroids after UAE, and the control group (group 2; n=42) included women without a history of uterine fibroids. Results. Women with uterine fibroids were statistically more likely to have grade 1 obesity (χ2=4.39; p=0.04) and less likely to have normal body weight (χ2=8.73; p=0.00) compared to women without fibroids. Smoking increased the risk of uterine fibroids twofold (χ2=4.49; p=0.03; odds ratio 1.97; confidence interval 0.64-6.11). More women with uterine fibroids had a history of abortions (n=42; 73.7%) than those without uterine fibroids (n=19; 45.2%; χ2=8.27; p=0.01). The most common gynecological comorbidities in women with uterine fibroids included inflammatory disease of the uterus (N71), endometrial polyp (N84), and endometriosis (N80); p0.05. The most common extragenital diseases in patients with uterine fibroids included thyroid disease, hypertension, and iron deficiency anemia (p0.05). Contour SE embolization agent with spherical particles was more often associated with pain (χ2=0.18; p=0.67) and less often with fever (χ2=4.47; p=0.03). There was a decrease in the number of short menstrual cycles (less than 24 days) from the moment before surgical treatment and after 24 months (χ2=34.580; p0.001) and an increase in the number of cycles of 24–38 days (χ2=14.887; p=0.005). At 24 months after UAE, there were more women with a menstrual period of less than 3 days (χ2=10.385; p=0.035) and fewer with a menstrual period of more than 8 days (χ2=34.573; p0.001). Ultrasound showed a decreased ovarian reserve at 6, 12 and 24 months after UAE (p0.05). Conclusion. When assessing the reproductive health of women 40 years and older after embolization of the uterine arteries, it was found that this method of treatment of symptomatic uterine fibroids leads to a decrease in the duration and heaviness of menstruation but increases the risk of an ovarian reserve decrease.

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Uterine Artery Embolization for the Treatment of Symptomatic Uterine Fibroids of Different Sizes: A Single Center Experience

Cited by 4 publications

References 80 publications

Currently Available Treatment Modalities for Uterine Fibroids

Currently Available Treatment Modalities for Uterine Fibroids

Risk factors affecting long-term efficacy of ultrasound-guided high-intensity focused ultrasound treatment for multiple uterine fibroids

Uterine artery embolization in the treatment of uterine fibroids and the preservation of reproductive health in women 40 years of age and older: A retrospective study

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