DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20150100

Uterine fibroids embolization in a tertiary hospital: our initial experience

Rooplekha Chouhan, Bharti Sahu, Pooja Verma, Sapna Chouhan

Abstract


Background: Uterine Fibroid Embolization (UFE) is a new modality which has appeared in the horizon for non-surgical management of many conditions including fibroids. Moderate to severe anemia with fibroids is one of the reasons for delay in definitive treatment. Need for blood transfusion and its consequent risk of adverse reactions and diseases became a necessity to consider alternative treatment. Objective: To evaluate the efficacy and safety of UFE as an alternative to major surgery.

Methods: Seventeen women with symptomatic uterine fibroids who declined surgery or were at poor risk for surgery were treated by Uterine Artery Embolization (UAE). The uterine arteries were catheterised and embolized with polyvinyl alcohol particles. The patients were followed up at regular interval clinically and with transabdominal ultrasonography.

Results: UAE performed on all 17 patients had no major complications. Clinical follow-up showed a significant reduction in symptoms within six months of the procedure, with 79% improvement in menorrhagia and 86%   improvement in pain. Follow-up imaging showed reduction in fibroid sizes ranging from 9-60%. The mean procedural time was 150 minutes. The mean hospital stay was 5 days (range, 3 to 10).

Conclusions: Mid-term results of UAE for the treatment of symptomatic fibroids in our hospital indicate this to be a safe and effective therapeutic option. 


Keywords


Fibroids, Embolization, Uterine artery, Minimal invasive

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References


Van den Bosch T, Coleman A, Morina M, Timmerman D, Amant F. Screening for uterine tumours. Best Pract Res Clin Obstet Gynaecol. 2012;26:257-66.

Divakar H. Asymptomatic uterine fibroids. Best Pract Res Clin Obstet Gynaecol. 2008;22:643-54.

Uba FA. Uterine fibroids: which treatment? Niger Med J. 2011;52:149.

Lumsden MA, Twaddle S, Hawthorn R, Traynor I, Gilmore D, Davis J, et al. A randomised comparison and economic evaluation of laparoscopic-assisted hysterectomy and abdominal hysterectomy. BJOG. 2000;107:1386-91.

Razavi MK, Hwang G, Jahed A, Modanlou S, Chen B. Abdominal myomectomy versus uterine fibroid embolization in the treatment of symptomatic uterine leiomyomas. AJR Am J Roentgenol. 2003;180:1571-5.

Narayan A, Lee AS, Kuo GP, Powe N, Kim HS. Uterine artery embolization versus abdominal myomectomy: a long-term clinical outcome comparison. J Vasc Interv Radiol. 2010;21:1011-7.

Walker WJ, McDowell SJ. Pregnancy after uterine artery embolization for leiomyomata: a series of 56completed pregnancies. Am J Obstet Gynecol. 2006;195:1266-71.

Ravina JH, Herbreteau D, Ciraru-Vigneron N, Bouret JM, Houdart E, Aymard A, et al. Arterial embolisation to treat uterine myomata. Lancet. 1995;346:671-2.

Kitamura Y, Ascher SM, Cooper C, Allison SJ, Jha RC, Flick PA, et al. Imaging manifestations of complications associated with uterine artery embolization. Radiographics. 2005;25(Suppl 1):S119-32.

Broder MS, Landow WJ, Goodwin SC, Brook RH, Sherbourne CD, Harris K. An agenda for research into uterine artery embolization: results of an expert panel conference. J Vasc Interv Radiol. 2000;11:509-15.

McLucas B, Goodwin S, Adler L, Rappaport A, Reed R, Perrella R. Pregnancy following uterine fibroid embolization. Int J Gynecol Obstet. 2001;74:1-7.

Goldberg J, Pereira L, Berghella V, Diamond J, Daraï E, Seinera P, et al. Pregnancy outcomes after treatment for fibromyomata: uterine artery embolization versus laparoscopic myomectomy. Am J Obstet Gynecol. 2004;191:18-21.

Katsumori T, Akazawa K, Mihara T. Uterine artery embolization for pedunculated subserosal fibroid, AJR Am J Roentgenol. 2005;184;399-402.