Uterine artery embolization for the treatment of symptomatic leiomyomata

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Abstract
Objective: To evaluate uterine artery embolization as an emerging minimally invasive technique in the treatment of patients symptomatic from uterine leiomyomata. Methods: Twenty patients (ages 31–52 years) underwent uterine artery embolization with permanent polyvinyl alcohol particles. Patients were assessed by the same examiner for uterine size and symptomatology. A questionnaire was answered as well as interval ultrasonography to assess uterine volume, as well as total fibroid volume. Volume was calculated using the formula for the prolate epsiloid. Results: At 1 year, 100% of patients with menorrhagia related to fibroids demonstrated complete resolution. One hundred percent of patients with mass symptomatology (pressure on adjacent structures, dyspareunia, or pelvic pain) reported improvement. All women stated that they would undergo the procedure again. Bilateral embolization was successful in all cases except one in which unilateral embolization was achieved. Decrease in uterine and fibroid volume ranged between 39% and 69% over 1 year. Commonly occurring postprocedural effects were low-grade fever and pain. One patient experienced a urinary tract infection; and, in another, an episode of pseudomembranous colitis related to prophylactic antibiotic use was documented by stool culture requiring rehospitalization. Nineteen of 20 patients returned to work within 3 weeks. Conclusions: Uterine artery embolization is a safe and effective alternative for women who desire less invasive management of leiomyomata.

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