Uterine artery embolisation for symptomatic fibroids.
Traditional operative treatments for symptomatic fibroids--hysterectomy and myomectomy--involve considerable morbidity. Although morbidity is reduced with endoscopic surgery, this technique is not widely available, and has limitations. Embolisation of the pelvic vasculature is not a new procedure, having been used to treat postpartum and postsurgical bleeding for 20 years. It has only recently been used to treat symptomatic fibroids. Uterine artery embolisation can produce a mean reduction of 29%-51% in uterine volume at the time of the three-month review, with longer follow-up showing continued shrinkage and no regrowth. The range of shrinkage is highly variable, which needs to be explained to all potential candidates. Symptomatic relief is a more certain outcome, with relief of pelvic pressure symptoms in 91%-96% of women. There is a small risk of complications requiring hysterectomy, and the long-term effect on ovarian function is unknown.
Dover
R W
RW
Royal North Shore Hospital, Sydney, NSW.
Torode
H W
HW
Briggs
G M
GM
D001158:Arteries; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D007044:Hysterectomy; D007889:Leiomyoma / Q000175:diagnosis / Q000628:therapy*; D010053:Ovary / Q000502:physiology; D018579:Patient Selection; D015641:Radiography, Interventional / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000628:therapy*; D014599:Uterus / Q000098:blood supply* / Q000473:pathology