Effecacy of Uterine Artery Embolization in the Management of Symptomatic Uterine Myomata
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- Category: Vol. 81, September 2013
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Effecacy of Uterine Artery Embolization in the Management of Symptomatic Uterine Myomata, WAEL S. NOSSAIR, MOHAMMED S. FARAG, HEND S. SALAH and MOHAMED M. TEAEMA
Abstract
Objective: The aim of the our study is to evaluate the results of the uterine artery embolization (UAE) as a modality for the treatment of uterine fibroids as regard to improvement of symptoms and reduction of fibroid size, and pregnancy after uterine artery embolization.
Design: Prospective clinical study.
Setting: Zagazig University Hospital, Obstetrics and Gynecology Department, Radiology Department. From period between January 2009 to July 2013.
Population: A total of 40 patients having symptomatic uterine fibroids (abnormal uterine bleeding, pelvic pain or bulk related symptoms) 20 of them were virgins and 20 were nullipara. Their ages ranged from 20-40 years.
Methods: All patient subjected to history taking, general examination, routine labolatory evaluation, ultrasound evalu-ation.
For all cases ultrasonography (abdominal and/or vaginal) was performed to measure the size of fibroid (s) before UAE. Then UAE using gel foam was performed occluding the feeding vessels for myomata. Evaluation of cases for reduction of tumour size and improvements of symptoms was performed one month, 3 months and 6 months after the procedure, long term follow-up of pregnancy occurrence.
Main outcome measures: Duration of technique, reduction of tumour size, significant improvement of symptoms, com-plications, pregnancy occurrence.
Results: The procedure was successful in 36 out of 40 cases (90%). Difficult or failed technique was encountered in four cases only. There was a significant reduction of tumour size and a non significant improvement of symptoms after one month. There were a significant and a highly significant improvement of symptoms after 3 and 6 months respectively and a highly significant reduction of tumour size at both 3 and 6 months. Subcutaneous hematoma, a small leak of contrast medium, fever with or without offensive vaginal discharge and pelvic pain were the complications noticed during or after UAE. Pregnancy occurred in 22/40 (55%) patients (some virgin patient married and got pregnancy) during long term flow-up. The fate of pregnancy was 2 abortions, 3 preterm labour, 1 IUFD, 16 term pregnancies.
Conclusions: UAE is an endovascular method for treatment of uterine fibroids that is clinically effective in most patients reducing the tumour size. It is invasive but relatively safe technique. Pregy can occur with long term follow-up.