Efficacy of uterine artery embolisation for treatment of symptomatic fibroids and adenomyosis - an interim report on an Australian experience.
BACKGROUND
Uterine artery embolisation (UAE) has been widely described internationally, however there is a paucity of data reported from Australia.


OBJECTIVE
To conduct a local audit on the efficacy and safety of UAE treating symptomatic fibroids and adenomyosis.


METHODS
Clinical data of 76 consecutive UAEs were reviewed. Degree of fibroid-related symptoms before embolisation and at follow-up visits were compared. Procedural and subsequent complications were recorded. Uterine and fibroid volumes were measured on MRI at baseline and six months post-UAE.


RESULTS
Seventy-six UAEs were performed in 75 women. Fifty-nine women had follow-up duration of more than six months, and one woman was lost to follow-up. Clinical success was 93% overall (n = 59) and 96% for menorrhagia (n = 49). For dysmenorrhoea (n = 36), 89% of women had at least some improvement, 75% had significant improvement and 56% had resolution of pain. For urinary symptoms (n = 32), 97% of women had at least some improvement and 50% had resolution of all urinary symptoms. Adenomyosis was found in 17 (29%) women treated. The primary success rate was 96%, and secondary success rate (after repeat UAE) was 100%. MRI showed 50% uterine volume reduction and 60% dominant fibroid volume reduction. There were no significant procedural-related acute complications. There were three possible cases of endometritis, two managed conservatively and one required hysterectomy.


CONCLUSIONS
This audit, based on local Australian experience, has confirmed that UAE is a safe and highly effective treatment for women with symptomatic fibroids and/or adenomyosis.
Department of Radiology, Sydney Adventist Hospital Clinical School, University of Sydney, New South Wales, Australia. eisenliang@gmail.com
Eisen
E
Liang
Bevan
B
Brown
Rodney
R
Kirsop
Paul
P
Stewart
Andrew
A
Stuart
D000328:Adult; D001315:Australia; D054869:Clinical Audit; D004412:Dysmenorrhea / Q000628:therapy; D004715:Endometriosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007889:Leiomyoma / Q000628:therapy*; D059012:Lost to Follow-Up; D008595:Menorrhagia / Q000628:therapy; D008875:Middle Aged; D009929:Organ Size; D016896:Treatment Outcome; D055357:Uterine Artery Embolization; D014599:Uterus / Q000033:anatomy & histology