The Long-term Results of Transcatheter Uterine Artery Embolization for Uterine Myoma

Objective To evaluate the long-term results and safety of transcatheter uterine artery embolization (TUAE) for u-terine myoma. Materials and Methods 231 cases of uterine myoma were treated by TUAE. The volumes of uterine myoma detected by ultrasound ranged from 19 cm3 to 504 cm3(mean, 121 cm3). There were intramural myoma in 191 cases, submucous myoma in 36 cases and subserous myoma in 4 cases, solitary in 16 cases and multiple in 215 cases. The TUAE through bilateral uterine arteries were performed using lipiodol-pingyingmycine emulsion (LPE) and gelatin sponge particles in 186 cases and using LPE aline in 45 cases. Clinical evaluation was made at regular intervals after embolization to assess patient outcome including the improvement of symptoms, reduction of the myoma volume and uterine volume, and the morbidity of recurrence, menoschsis and complications. Results The follow-up period ranged from 6 to 48 months. Menorrhagia became normal or improved markedly in 96.0% (193/201). Lumbago and lower abdominal pain disappeared or improved markedly in 94.9% (94/99). Bulk-related symptoms disappeared or improved markedly in 96.0% (48/50) . Ultrasound revealed that the mean largest tumor volume reduction rates were 60.7% at 1 year, 63.3% at 2 year, 65 .6% at 3 year and 67.4% at 4 year after embolization, and the mean u-terine volume reduction rates were 49.6% at 1 year, 54.3% at 2 year, 55.2% at 3 year and 57.1 % at 4 year after embolization. No new myoma occurred. Complications included ecchymosis and ulceration on buttock ( n = 1) ; ulcer of latia minora (n = 1); urinary retention ( n = 12) ; urinary tract infection ( n = 1); expelling of necrotic fibroids per vagina ( n = 24) ; secondary infection of chocolate cyst of ovary ( n = 1); increasing in endometrial thickness and calcification ( n = 1) and amenorrhea ( n = 2). Conclusion TUAE is associated with a good long-term efficiency. Some serious complications or sequelae can be caused in few patients.