title: Uterine artery embolization to treat uterine adenomyosis with or without uterine leiomyomata: results of symptom control and health-related quality of life 40 months after treatment.
abstract: OBJECTIVE
  To evaluate the clinical outcome for uterine adenomyosis with or without uterine leiomyomata 40 months after uterine artery embolization (UAE).
  
  
  METHODS
  Forty women aged 39-56 years (median 46 years) with symptomatic uterine adenomyosis and magnetic resonance imaging findings of uterine adenomyosis with or without combined uterine leiomyomata underwent UAE. Self-perceived changes in clinical symptoms were assessed, and residual symptom severity and health-related quality of life (HRQOL) after UAE were evaluated. Clinical failure was defined as no symptomatic improvement or second invasive therapy after UAE. Results were stratified by the extent of uterine adenomyosis at baseline magnetic resonance imaging.
  
  
  RESULTS
  Patients were followed for a median of 40 months (range 5-102 months). UAE led to symptomatic control after UAE in 29 (72.5%) of 40 patients while 11 women underwent hysterectomy (n=10) or dilatation and curettage (n=1) for therapy failure. No significant difference between women with pure uterine adenoymosis and women with uterine adenomyosis combined with uterine leiomyomata was observed. Best results were shown for UAE in uterine adenomyosis with uterine leiomyomata predominance as opposed to predominant uterine adenomyosis with minor fibroid disease (clinical failure 0% vs. 31.5%, P=0.058). Throughout the study group, HRQOL score values increased and symptom severity scores decreased after UAE. Least improvement was noted for women with pure adenomyosis.
  
  
  CONCLUSIONS
  UAE is clinically effective in the long term in most women with uterine adenomyosis. Symptomatic control and HRQOL were highest in patients with combined disease of uterine adenomyosis but leiomyomata predominance.
authors.affiliation: Department of Radiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13553, Berlin, Germany. Vera.Froeling@charite.de
authors.forename: V
authors.initials: V
authors.lastname: Froeling
authors.forename: C
authors.initials: C
authors.lastname: Scheurig-Muenkler
authors.forename: B
authors.initials: B
authors.lastname: Hamm
authors.forename: T J
authors.initials: TJ
authors.lastname: Kroencke
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D004107:Dilatation and Curettage; D004621:Embolization, Therapeutic / Q000379:methods*; D004715:Endometriosis / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D053208:Kaplan-Meier Estimate; D007889:Leiomyoma / Q000150:complications / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008863:Microspheres; D008875:Middle Aged; D011142:Polyvinyl Alcohol / Q000627:therapeutic use; D011788:Quality of Life; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000150:complications / Q000628:therapy
chemical_list: D011142:Polyvinyl Alcohol