PRELIMINARY EXPERIENCE WITH UTERINE ARTERY EMBOLIZATION FOR UTERINE FIBROIDS

PURPOSE: To evaluate the potential usefulness of transcatheter uterine artery embolization as a treatment for fibroid-related vaginal bleedi ng and pelvic pain refractory to hormonal therapy and myomectomy. MATE RIALS AND METHODS: Eleven patients (aged 27-55 years; mean, 44.2 years ; none desiring future pregnancy) with refractory vaginal bleeding and /or chronic pelvic pain related to uterine leiomyomata underwent uteri ne artery embolization with use of polyvinyl alcohol (PVA) particles, Clinical improvement was assessed by detailed questionnaire at 2-9 mon ths (mean, 5.8 months) after the procedure, Sonographic measurements o f the uterus and dominant masses were obtained before and at 2 months after the procedure. RESULTS: All 11 patients underwent technically su ccessful embolization, Eight of nine women who completed the follow-up questionnaire reported noticeable symptomatic improvement, including three women with complete resolution of symptoms, One woman (the only patient undergoing unilateral embolization) exhibited no clinical resp onse, Another patient developed endometritis and pyometra 3 weeks afte r the procedure, necessitating hysterectomy, Large reductions in uteri ne volume (average, 40%) and dominant fibroid size (average, 60%-65%) were sonographically demonstrated, CONCLUSION: Uterine artery emboliza tion represents a promising new method of treating fibroid-related men orrhagia and pelvic pain, Further investigation will be required to as sess clinical response and durability, identify appropriate candidates , and define the optimal angiographic technique and PVA particle size.