Uterine Artery Embolization in 101 Cases of Uterine Fibroids: Do Size, Location, and Number of Fibroids Affect Therapeutic Success and Complications?

Abstract

The purpose of this study was to evaluate whether the size, location, or number of fibroids affects therapeutic efficacy or complications of uterine artery embolization (UAE). Patients with symptomatic uterine fibroids (n = 101) were treated by selective bilateral UAE using 500- to 710-mum polyvinyl alcohol (PVA) particles. Baseline measures of clinical symptoms, sonography, and MRI taken before the procedure were compared to those taken 1, 3, 6, and 12 months later. Complications and outcomes were analyzed for associations with fibroid size, location, and number. Reductions in mean fibroid volume were similar in patients with single (66.6 +/- 21.5%) and multiple (67.4 +/- 25.0%) fibroids (p-value = 0.83). Menstrual improvement occurred in patients with single (93.3%) and multiple (72.2%) fibroids (p = 0.18). Changes in submucosal and other fibroids were not significantly different between the two groups (p's > 0.56). Linear regression analysis between primary fibroid volume as independent variable and percentage reduction of fibroid volume after 1 year yielded an R(2) of 0.083 and the model coefficient was not statistically significant (p = 0.072). Multivariate regression models revealed no statistically or clinically significant coefficients or odds ratios for three independent variables (primary fibroid size, total number, and fibroid location) and all outcome variables (percent reduction of uterus and fibroid volumes in 1 year, improvement of clinical symptoms [menstrual, bulk related, and urinary] in 1 year, and complications after UAE). In conclusion, neither the success rate nor the probability of complications was affected by the primary fibroid size, location, or total number of fibroids.

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

“…Spies et al [30] reported 90% resolution of heavy bleeding (95% CI, 86-95%) and 91% improvement in bulk-related symptoms (95% CI, 86-95%) at 1 year. In an earlier study [31], we found resolution of menstrual bleeding in 81.8% of the patients and relief of bulk-related symptoms in 84.6%.…”

Hyperkalemia and acute kidney failure associated with preoperative uterine artery embolization for a large uterine fibroid: a case report

“…Previous reports found that the size of the uterine fibroid was not associated with complications after UAE [7–10]. In one report, complications were found to be associated with a large uterus size (500 mL), large dominant tumor volume (100 cm 3 ), and high post-intervention creatine kinase level (170 U/L) [11].…”

“…In one report, complications were found to be associated with a large uterus size (500 mL), large dominant tumor volume (100 cm 3 ), and high post-intervention creatine kinase level (170 U/L) [11]. Among previous reports, the largest fibroid was approximately 4000 cm 3 [7–10], while the uterus in the present case was 9964 cm 3 ; therefore, it was not possible to generalize the previous findings to the present case. In our case, fibroid volume was the most important risk factor for serious complications.…”

Comparing Ovarian Radiation Doses in Flat-Panel and Conventional Angiography During Uterine Artery Embolization: A Randomized Clinical Trial

“…Transient amenorrhea after this procedure is rare and persistent amenorrhea occurs in less than 1% (2, 3). Advanced maternal age adversely affects ovarian function; causing a decrease in the number of good quality oocytes and chromosomally abnormal conceptions that rarely develops further.…”