Uterine arterial embolization for the management of leiomyomas: quality-of-life assessment and clinical response.
OBJECTIVE
To determine the effectiveness of uterine arterial embolization as a primary therapy in the management of symptomatic leiomyomas.


METHODS
Uterine arterial embolization was performed in 53 patients (age range, 33-58 years) with menorrhagia, bulk-related symptoms (frequency of urination, sensation of pressure, sensation of mass), or both, due to leiomyomas. The effectiveness of this therapy in the control of symptoms and the patients' acceptance of the treatment were measured by means of the information from patient interviews 3 months after the procedure.


RESULTS
Fifty-two (98%) of the 53 patients had technically successful procedures and were interviewed 3 months after embolization. Forty-six (88%) of these patients reported marked improvement in their abnormal bleeding. Twenty-nine (94%) of the 31 patients with bulk-related symptoms reported marked improvement in these symptoms. Follow-up ultrasonographic examinations showed a mean 46% reduction in uterine volume. Forty-one patients interviewed (79%) would choose this procedure again, eight (15%) would consider choosing this procedure again, and only three (6%) would choose another treatment option.


CONCLUSIONS
Uterine arterial embolization is an effective therapy in the management of symptomatic leiomyomas and may prove to be a valuable alternative to myomectomy, hysterectomy, or other surgical procedures. Further investigation is warranted.
Department of Radiology, Philadelphia College of Osteopathic Medicine, Pa, USA.
R L
RL
Worthington-Kirsch
G L
GL
Popky
F L
FL
Hutchins
D000328:Adult; D000792:Angiography; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000098:blood supply / Q000628:therapy*; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000098:blood supply / Q000628:therapy*