A case report: uterine fibroids treated by polyvinyl alcohol particles


  • Sudhanshu Tonpe Department of Interventional Radiology, Government Medical College and Hospital-Nagpur, Nagpur, Maharashtra, India
  • Himandri Harish Warbhe Department of Respiratory Medicine, Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India




Case report, DUB, Endovascular uterine artery embolization, PVA


Uterine fibroids, the most common type of tumor among women of reproductive age, are associated with heavy menstrual bleeding, sub-fertility, abdominal discomfort, and a reduced quality of life. For women who wish to preserve their uterus and who have not had a response to medical treatment, uterine artery embolization and myomectomy are therapeutic options. A 35-year-old asthmatic female came to our hospital with dysfunctional uterine bleeding (DUB) from the past 6 months complicated by severe anemia requiring multiple blood transfusions. Ultrasound of the pelvis shows a bulky uterus with an intramural fundal fibroid indenting the endometrial cavity with fluid collection within. Considering the age and reduced Hemoglobin and the co-morbidity of asthma, endovascular PVA (Polyvinyl alcohol particle) particle embolization of both uterine arteries was performed. Post procedure, there was there were no acute symptoms. Six months after the intervention, the patient’s pelvic USG shows significant reduction in the size of the fundal fibroid with total absence of menstrual bleeding. Therefore, endovascular uterine artery embolization with PVA particles is safe and effective method to treat DUB.

Author Biography

Sudhanshu Tonpe, Department of Interventional Radiology, Government Medical College and Hospital-Nagpur, Nagpur, Maharashtra, India


Department of Interventional radiology.


Stewart EA, Cookson CL, Gandolfo RA, Schulze-Rath R. Epidemiology of uterine fibroids: a systematic review. BJOG. 2017;124:1501-12.

Lurie S, Piper I, Woliovitch I, Glezer- man M. Age-related prevalence of sono- graphicaly confirmed uterine myomas. J Obstet Gynaecol. 2005;25:42-4.

Drayer SM, Catherino WH. Preva- lence, morbidity, and current medical management of uterine leiomyomas. Int J Gynaecol Obstet. 2015;131:117-22.

Downes E, Sikirica V, Gilabert- Estelles J. The burden of uterine fi- broids in five European countries. Eur J Obstet Gynecol Reprod Biol. 2010;152:96-102.

Borah BJ, Nicholson WK, Bradley L, Stewart EA. The impact of uterine leio- myomas: a national survey of affected women. Am J Obstet Gynecol. 2013;209(4):319.e1-319.e20.

Somigliana E, Vercellini P, Daguati R, Pasin R, De Giorgi O, Crosignani PG. Fibroids and female reproduction: a critical analysis of the evidence. Hum Reprod Up-date 2007;13:465-76.

Pritts EA, Parker WH, Olive DL. Fi- broids and infertility: an updated systematic review of the evidence. Fertil Steril. 2009;91:1215-23.

Sundermann AC, Velez Edwards DR, Bray MJ, Jones SH, Latham SM, Hartmann KE. Leiomyomas in pregnancy and spon- taneous abortion: a systematic review and meta-analysis. Obstet Gynecol. 2017;130:1065-72.

Metwally M, Cheong YC, Horne AW. Surgical treatment of fibroids for subfer- tility. Cochrane Database Syst Rev. 2012;11:CD003857.

Mara M, Maskova J, Fucikova Z, Kuzel D, Belsan T, Sosna O. Midterm clinical and first reproductive results of a randomized controlled trial comparing uterine fibroid embolization and myomectomy. Cardiovasc Intervent Radiol. 2008;31:73-85.

Manyonda IT, Bratby M, Horst JS, Banu N, Gorti M, Belli A-M. Uterine artery embolization versus myomectomy: impact on quality of life-results of the FUME (Fibroids of the Uterus: Myomectomy versus Embolization) Trial. Cardiovasc Intervent Radiol. 2012;35:530-6.

El Shamy T, Amer SAK, Mohamed AA, James C, Jayaprakasan K. The impact of uterine artery embolization on ovarian reserve: a systematic review and meta- analysis. Acta Obstet Gynecol Scand. 2020;99:16-23.

Ravina JH, Herbreteau D, Ciraru-Vigneron N. Arterial embolisation to treat uterine myomata. Lancet. 1995;346:671-2.

Goodwin SC, Vedantham S, McLucas B, Forno AE, Perrella R. Preliminary experience with uterine artery embolization for uterine fibroids. J Vasc Interv Radiol. 1997;8:517-26.

Worthington-Kirsch RL, Popky GL, Hutchins FL. Uterine arterial embolization for the management of leiomyomas: quality-of-life assessment and clinical response. Radiology. 1998;208:625-9.

Spies JB, Scialli AR, Jha RC. Initial results from uterine fibroid embolization for symptomatic leiomyomata. J Vasc Interv Radiol. 1999;10:1149-57.

Goodwin SC, McLucas B, Lee M. Uterine artery embolization for the treatment of uterine leiomyomata: midterm results. J Vasc Interv Radiol. 1999;10:1159-65.

Choe DH, Moon HH, Gyeong HK, Kyung MY, Man CH. An experimental study of embolic effect according to infusion rate and concentration of suspension in transarterial particulate embolization. Invest Radiol. 1997;32:260-7.

Siskin GP, Eaton LA, Stainken BF, Dowling K, Herr A, Schwartz J. Pathologic findings in a uterine leiomyoma after bilateral uterine artery embolization. J Vasc Interv Radiol. 1999;10:891-4.

Aziz A, Petrucco OM, Mikinoda S. Transarterial embolization of the uterine arteries: patient reactions and effects on uterine vasculature. Acta Obstet Gynecol Scand. 1998;77:334-40.

McLucas B, Goodwin SC, Kaminsky D. The embolised fibroid uterus. Min Invas Ther Allied Technol. 1998;7:267-71

Abbara S, Spies JB, Scialli AR, Jha RC, Lage JM, Nikolic B. Transcervical expulsion of a fibroid as a result of uterine artery embolization for leiomyomata. J Vasc Interv Radiol. 1999;10:409-11.






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