Uterine Artery Embolization for the Treatment of Adenomyosis: A Review

Adenomyosis: A Clinical Review of a Challenging Gynecologic Condition

“…The median follow-up from these studies was 26.9 months. 89 However commonly reported side effects include pelvic pain, nausea, and fever due to ischemic necrosis. 90 Nearly 5% of patients suffer a major complication such as infection, hemorrhage, or unplanned surgical procedure.…”

Uterine Artery Embolization for Adenomyosis: Percentage of Necrosis Predicts Midterm Clinical Recurrence

“…They reviewed divergent evaluations to reach consensus. The MR imaging diagnostic criteria of adenomyosis included a 4 12-mm thickening of the junctional zone with or without punctate high-signal intensity myometrial foci on T1-weighted or T2-weighted imaging (4,5). The type of adenomyosis was classified as focal or diffuse on the basis of T2-weighted images at baseline (10)(11)(12).…”

“…Surgical hysterectomy is considered the only definitive treatment for adenomyosis (3), although uterine artery embolization (UAE) has been used as a minimally invasive alternative to surgery. Previous reports showed favorable short-term outcomes regarding symptom relief after UAE (4)(5)(6); however, recurrence rates were reported to increase with longer follow-up period (4,7).…”

Indications and Alternatives to Hysterectomy

“…A systematic review, that did not focus on AUB, nonetheless reported 511 patients from 15 studies with a mean follow-up of 27 months where 76% of the enrolled patients reported improved symptoms. 16 The experimental designs, including relatively small sample size and heterogeneity of the subjects included in these studies, limits generalizability of these results, but suggests that while there may be benefit to selected women with AUB-A, the durability of the response may be limited. Another approach being considered is the performance of targeted hyperthermal ablation, reported most recently with image-guided high-frequency ultrasound.…”