Is uterine artery embolization prior to myomectomy for giant fibroids helpful?
OBJECTIVE
To determine whether uterine artery embolization (UAE) prior to myomectomy is more effective than myomectomy alone.


METHODS
The study included 15 consecutive infertile women with uterine fibroids > 10 cm (Group I) that underwent UAE with spherical particles using a microcatheter technique and a unilateral femoral approach between March 2005 and January 2007. The day after embolization all cases underwent myomectomy since the protocol for large fibroids in our hospital is myomectomy only. The control group was composed of 15 patients who underwent myomectomy only (Group II). Group II was established based on fibroid size (14 +/- 3 cm). Operating time, estimated blood loss and transfusion, complications, and hospital stay were calculated by retrospective chart reviews, and comparisons were made between the groups with Student's t-test.


RESULTS
Mean operating time was 138 min in Group I and 240 minutes in Group II (P < 0.01). Mean estimated blood loss was 250 ml in Group I and 690 ml in Group II (P < 0.01). There was no need for transfusion in Group I, while transfusion was needed in 2 cases (13%) in Group II. Mean hospital stay in Group I was 5 days versus 8 days in Group II. Complications, including subsequent hysterectomy, were seen in 2 cases and bowel-bladder injuries in 1 case in Group II (a total of 20%), while no complications were observed in Group I. One of the cases in Group I later conceived and gave birth to a healthy child.


CONCLUSIONS
UAE prior to myomectomy is more effective than myomectomy alone.
Ustünsöz
Bahri
B
Department of Radiology, Gülhane Military Medical Academy, Ankara, Turkey. bustunsoz2000@yahoo.com
Uğurel
Mehmet Sahin
MS
Bozlar
Uğur
U
Duru
Namik Kemal
NK
Ustünsöz
Ayfer
A
D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D008499:Medical Records; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014421:Turkey; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D014599:Uterus / Q000098:blood supply*