Uterine artery embolization for uterine fibroids:mid-long term follow up

Objective To evaluate the mid-long term effects of uterine fibroids embolization. Methods Uterine artery embolization (UAE) was performed in 110 patients with uterine fibroids with follow up of 48 - 72 months. All the patients were examined with transvaginal color ultrasound. 51 cases were embolized with mixed liquor of lipiodol and pingyangmycin and another 59 cases with polyvinyl alcohol particles (350 ～ 700 μm, in diameter). The mid-long term clinical effects, complications, change of serum sexual hormone, pregnancy and delivery after UAE were observed. Results Bilateral uterine artery embolization was performed in 110 cases with following outcomes in improvements of menorrhagia in 93/94(98.9%) and the bulked-related symptoms in 26/26(100%), decrease of the volumes of uterus 51.5% ± 3.1%(t value 2.861,P 0.01)and fibroids 64.2% ± 6.6%(t value 2.664,P 0.01). No statistical differences in serum levels of luteinizing, follicle stimulating hormone and estradiol before and after the uterine artery embolization were found. All events included abdominal pain in 6/110 (5.5%), fever in 90/110(81.8%), colporrhagia in 95/110(86.4%), haematuria in 11/110 (10.0%), non-targeted embolization of bladder in 1/110 (0.9%), transient amenorrhea in 3/110 (2.7%), permanent amenorrhea due to ovarian failure in 3/110(2.7%), failure of embolization in 1/110(0.9%)and recurrence after uterine fibroids embolization in 4/110(3.6%). There were 7 times of pregnancies in 5 patients, including 4 times of deliveries in 4 patients, and one patient accepted artificial abortion 3 times, but with no fibroids recurrences or enlargement under ultrasound follow up. Conclusion The mid-long term effects of uterine fibroids embolization are positive, stable and safe, but with a low recurrence rate slight ovarian functional change and still safe for pregnancy and delivery. (J Intervent Radiol, 2006, 15: 539-542)