Experience with collaborative management of symptomatic fibroids by gynecology and interventional radiology.
Objective: The purpose of this paper is to review the initial collaborative experience of a gynecologist and an interventional radiologist in the utilization of embolotherapy in the management of symptomatic uterine myomas.Methods: One hundred five consecutive subjects treated by embolotherapy were selected for review. All patients derived from a single gynecologic practice and were evaluated by the same examiner, using standardized criteria. Embolotherapy was carried out in all subjects by the same interventional radiologist using 500-700 µm polyvinyl alcohol particles injected bilaterally into the uterine arteries utilizing uniform technique and endpoints.Results: Size reduction of 20-85% confirmed by follow-up ultrasound was achieved. Ninety percent of patients noted improvement in their overall symptoms. Eighty percent of patients were able to resume normal activity 4 days after therapy, the remainder of 20% within 2 weeks. One patient subsequently underwent hysterectomy. At 1-year follow-up, changes in size and menorrhagia persisted.Conclusion: The collaborative treatment of fibroids by gynecologists and interventional radiologists appears to offer an effective alternative to women with symptomatic uterine fibroids.
Hutchins
FL
Department of Obstetrics and Gynecology, Allegheny University Hospital, City Avenue, Pennsylvania, Philadelphia, USA
Worthington-Kirsch
RL