title: Long-term follow-up of uterine artery embolization for symptomatic adenomyosis.
abstract: BACKGROUND
  Long-term results of uterine artery embolization (UAE) for adenomyosis are largely unknown. We assess long-term outcome of UAE in 40 women with adenomyosis.
  
  
  METHODS
  Between March 1999 and October 2006, 40 consecutive women with adenomyosis (22 in combination with fibroids) were treated with UAE. Changes in junction zone thickness were assessed with magnetic resonance imaging (MRI) at baseline and again at 3 months. After a mean clinical follow-up of 65 months (median 58 [range 38-129]), women filled out the uterine fibroid symptom and quality of life (UFS-QoL) questionnaire, which had additional questions on the long-term evolution of baseline symptoms and adverse events.
  
  
  RESULTS
  During follow-up, 7 of 40 women (18%) underwent hysterectomy. Among these 7 women, the junction zones were significantly thicker, both at baseline (mean 23 vs. 16 mm, P = 0.028) and at 3-month follow-up (mean 15 vs. 9 mm, P = 0.034). Of 33 women with preserved uterus, 29 were asymptomatic. Four patients had symptom severity scores of 50 to 85 and overall QoL scores of 60 to 66, indicating substantial clinical symptoms. There was no relation between clinical outcome and the initial presence of fibroids in addition to adenomyosis.
  
  
  CONCLUSIONS
  In women with therapy-resistant adenomyosis, UAE resulted in long-term preservation of the uterus in the majority. Most patients with preserved uterus were asymptomatic. The only predictor for hysterectomy during follow-up was initial thickness of the junction zone. The presence or absence of fibroids in addition to adenomyosis had no relation with the need for hysterectomy or clinical outcome.
authors: Department of Radiology, St. Elisabeth Ziekenhuis, Tilburg, The Netherlands. radiol@eztilburg.nl
authors: A J
authors: AJ
authors: Smeets
authors: R J
authors: RJ
authors: Nijenhuis
authors: P F
authors: PF
authors: Boekkooi
authors: H A M
authors: HA
authors: Vervest
authors: W J
authors: WJ
authors: van Rooij
authors: P N M
authors: PN
authors: Lohle
mesh_terms: D062788:Adenomyosis / Q000175:diagnosis / Q000628:therapy*; D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D007889:Leiomyoma / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000379:methods*