Document Detail


Long-term results of uterine artery embolization for symptomatic adenomyosis.
MedLine Citation:
PMID:  17179361     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Controversy exists regarding the effectiveness of uterine artery embolization (UAE) in the management of symptomatic adenomyosis. The aim our study was to determine the long-term clinical efficacy of UAE in the management of symptomatic adenomyosis without fibroids. MATERIALS AND METHODS: The cases of all patients who underwent UAE for adenomyosis without fibroids between 1998 and 2000 were analyzed. This study was a retrospective review of a prospectively collected database. Of the 66 patients, 54 patients with a follow-up period of 3 years or longer were enrolled in the study. Twelve patients were lost to follow-up. The patients' ages ranged from 29 to 49 years (mean, 40.2 years). The mean follow-up period was 4.9 years (range, 3.5-5.8 years). The primary embolic agent was polyvinyl alcohol particles (250-710 microm). All patients underwent MRI before UAE. Long-term follow-up MRI was performed on 29 patients; 22 of these patients had undergone short-term (3.5 months) follow-up MRI. Uterine volume was calculated with MR images. Symptom status in terms of menorrhagia and dysmenorrhea was scored on a scale of 0-10, 0 being no symptoms and 10 being the baseline, or initial symptoms. RESULTS: Thirty-one (57.4%) of the 54 women who underwent follow-up had long-term success. Four had immediate treatment failure, and 19 had relapses. Changes in mean menorrhagia and dysmenorrhea scores at long-term follow-up were -5.3 and -5.1, respectively (p < 0.001), representing significant relief of symptoms. The time between UAE and recurrence of symptoms ranged from 4 to 48 months (mean, 17.3 months). Five patients underwent hysterectomy because of symptom recurrence. Mean reduction in volume of the uterus was 26.3% at short-term follow-up and 27.4% at long-term follow-up. CONCLUSION: We found that UAE is effective in the management of symptomatic adenomyosis and has an acceptable long-term success rate. UAE should be considered a primary treatment method for patients with symptomatic adenomyosis. However, all patients should be given an explanation of the possibility of treatment failure, recurrence, and the need for hysterectomy.
Authors:
Man Deuk Kim; Sehuyn Kim; Nahk Keun Kim; Mee Hwa Lee; Eun Hee Ahn; Hee Jin Kim; Jin Ho Cho; Sun Hee Cha
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  188     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2006-12-20     Completed Date:  2007-01-09     Revised Date:  2008-02-15    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  176-81     Citation Subset:  AIM; IM    
Affiliation:
Department of Diagnostic Radiology, Bundang CHA General Hospital, Pochon CHA University, 351 Yatap-dong, Bundang-gu, Sungnam-si, Kyonggi-do, 463-712, Republic of Korea. mdkim@cha.ac.kr
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MeSH Terms
Descriptor/Qualifier:
Adult
Embolization, Therapeutic / methods*
Endometriosis / diagnosis,  surgery*
Female
Humans
Longitudinal Studies
Magnetic Resonance Imaging
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Uterine Neoplasms / diagnosis,  surgery*
Uterus / blood supply*,  surgery*

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