Uterine Artery Embolization in The Treatment of Symptomatic Leiomyoma: Effect on Ovarian Function, Clinical Symptoms and Its Complications: Effect of uterine artery embolization on leiomyoma
Introduction: The present study evaluated the effect of uterine artery embolization on preservation of fertility in leiomyoma and its complications.
Materials and Methods: Thirty women with leiomyoma were included in the present study. Hormonal levels, leiomyoma size, patients’ symptoms and complications if developed were evaluated, both before and after uterine artery embolization.
Results: There was no significant difference between the mean follicle-stimulating hormone, luteinizing hormone and estradiol levels, before and after uterine artery embolization (p=0.431, p=0.672, p=0.772, respectively). Fibroids size measured before and after 6 months of uterine artery embolization were 86.47 ± 28.42 cm and 59.80 ± 20.90 cm, respectively (p<0.001). None of the patients developed complications such as embolism, wound problems or necessity for hysterectomy. After uterine artery embolization, symptoms such as hypermenorrhea, dysmenorrhea, dyspareunia, and dysuria decreased significantly among patients.
Conclusions: Our findings showed that uterine artery embolization is an appropriate choice for patients with leiomyoma, to control and relieve symptoms, to reduce fibroid size, and finally to maintain fertility among those women.
Bulman JC, Ascher SM, Spies JB. Current concepts in uterine fibroid embolization. Radiographics. 2012;32(6):1735-50.
Chrisman HB1, Saker MB, Ryu RK, Nemcek AA Jr, Gerbie MV, Milad MP and et al. The impact of uterinefibroid embolization on resumption of menses and ovarian function. J Vasc Interv Radiol. 2000;11:699–703
Edwards RD, Moss JG, Lumsden M. Uterine-artery embolization versus surgery for symptomatic uterine fibroids. N Engl J Med. 2007;356(4):360-70
Firouznia K, Ghanaati H, Jalali AH, Shakiba M. Uterine Artery Embolization for Treatment of Symptomatic Fibroids: A Review of the Evidence. Iran Red Crescent Med J. 2013;15(12):e16.
Gupta JK1, Sinha A, Lumsden MA, Hickey M. Uterine artery embolization for symptomatic uterine fibroids. Cochrane Database Syst Rev. 2012;16(5):CD005073.
Jacoby VL, Autry A, Jacobson G, Domush R, Nakagawa S, Jacoby A. Nationwide Use of Laparoscopic Hysterectomy Compared With Abdominal and Vaginal Approaches. Obstet Gynecol. 2009;114(5):1041–8.
Jun F, Yamin L, Xinli X, Hickey M. Uterine artery embolization for symptomatic uterine fibroids. Cochrane Database Syst Rev. 2006 Jan 25;(1):CD005073
McLucas B, Adler L, Perella R. Predictive factors for success in uterine fibroid embolisation. Min Invas Ther Allied Technol. 1999;8:429–32.
Moss JG, Cooper KG, Khaund A, Murray LS, Murray GD, Wu O and et al. Randomized comparison of uterine artery embolisation (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST trial): 5-year results. BJOG. 2011;118(8):936-44.
Orsini LF, Salardi S, Pilu G , Bovicelli L, Cacciari E. Pelvic organs in premenarchal girls: real-time ultrasonography. Radiology. 1984;153:113–6.
Payson, M., P. Leppert, and J. Segars, Epidemiology of myomas. Obstet Gynecol Clin North Am. 2006;33(1):1-11.
Ravina JH1, Herbreteau D, Ciraru-Vigneron N, Bouret JM, Houdart E, Aymard A, et al. Arterial embolization to treat uterine myomata. Lancet. 1995;346(8976):671-2.
Rashid S, Khaund A, Murray LS, Moss LG, Cooper K, Lyons D, et al. The effects of uterine artery embolization and surgical treatment on ovarian function in women with uterine fibroids. BJOG. 2010;117(8):985-9.
Spies JB1, Roth AR, Gonsalves SM, Murphy-Skrzyniarz KM. Ovarian function after uterine artery embolization for leiomyomata: assessment with use of serum follicle stimulating hormone assay. J Vasc Interv Radiol. 2001;12:437–42.
Tropeano G1, Di Stasi C, Litwicka K, Romano D, Draisci G, Mancuso S. Uterine artery embolization for fibroids does not have adverse effects on ovarian reserve in regularly cycling women younger than 40 years. Fertil Steril. 2004;81(4):1055-61.
Volkers NA1, Hehenkamp WJ, Birnie E, Ankum WM, Reekers JA. Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids: 2 years' outcome from the randomized EMMY trial. Am J Obstet Gynecol. 2007;196(6): 745.e1-745.e12.
Walker WJ1, Pelage JP. Uterine artery embolization for symptomatic fibroids: clinical results in 400 women with imaging follow up. BJOG. 2002;109(11):1262-72.
Zhang HX1, Chen SQ, Jiang HY, Yao SZ. Laparoscopic uterine anastomosis for traumatic separation of the cervix from the uterine corpus caused by closed pelvic fracture: case report and literature review. J Minim Invasive Gynecol. 2013;20(2):244-7.
This work is licensed under a Creative Commons Attribution 4.0 International License.