Failure of uterine fibroid embolization.
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.
Huang
Jack Y J
JY
Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.
Kafy
Souzan
S
Dugas
Alexandre
A
Valenti
David
D
Tulandi
Togas
T
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*
D011142:Polyvinyl Alcohol