title: Failure of uterine fibroid embolization.
abstract: OBJECTIVE
  To assess the outcomes of patients who underwent uterine fibroid embolization (UFE) and to evaluate factors associated with failure of UFE.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  Two hundred thirty-three consecutive patients who underwent UFE from November 1997 to February 2004.
  
  
  METHODS
  Uterine fibroid embolizations were performed by three interventional radiologists using 355-500-mu polyvinyl alcohol particles.
  
  
  METHODS
  Hysterectomy rate, myomectomy rate, and repeat UFE rate.
  
  
  RESULTS
  With a mean follow-up of 13 months, a total of 22 patients underwent surgery after UFE (9.4%); 16 had hysterectomies (6.9%), and 6 had myomectomies (2.6%). This included 3 patients who underwent repeat UFE and subsequently required surgical intervention. The mean (+/- SEM) time interval between UFE and subsequent treatment was 12.5 +/- 2.0 months. Among patients who required surgery, 13 (59.1%) presented with recurrent menorrhagia, and 5 (22.7%) complained of persistent abdominal pain. Histopathologic examination revealed concomitant findings of adenomyosis in 25% of hysterectomy specimens. Patients who failed UFE were more likely to have had a previous myomectomy (13% vs. 2.4%) and significant reduction in the uterine size 6 months after UFE (57.1% vs. 25.2%).
  
  
  CONCLUSIONS
  The overall failure rate of UFE is 9.4%. Failure is mainly due to persistent menorrhagia and abdominal pain. Shrinkage of the uterus after UFE does not necessarily correlate with long-term success of UFE.
authors.affiliation: Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.
authors.forename: Jack Y J
authors.initials: JY
authors.lastname: Huang
authors.forename: Souzan
authors.initials: S
authors.lastname: Kafy
authors.forename: Alexandre
authors.initials: A
authors.lastname: Dugas
authors.forename: David
authors.initials: D
authors.lastname: Valenti
authors.forename: Togas
authors.initials: T
authors.lastname: Tulandi
mesh_terms: D000328:Adult; D004621:Embolization, Therapeutic / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D008595:Menorrhagia; D009215:Myometrium / Q000473:pathology / Q000601:surgery; D011142:Polyvinyl Alcohol; D011183:Postoperative Complications; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D017211:Treatment Failure; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*
chemical_list: D011142:Polyvinyl Alcohol