Uterine Artery Embolization as Therapy for Myomata
- Created: January 7, 2000
- by: admin
By: Bruce McLucas, MD, and Louis Adler, MD
CONTROVERSIES IN REPRODUCTIVE SURGERIES
January 2000 Volume 11 pp. 77-94
Uterine artery embolization is a proven method for the treatment of myomata. Patients undergoing UAE have a high likelihood of symptom relief and improvement in menorrhagia (67%) as well as a reduction in uterine size as reflected in total uterine volume (56%) and individual myoma dimensions (36%). Patients from both of the authors’ centers have achieved equal success in shrinkage. There have been no reports of recurrence, suggesting the permanence of this nonsurgical procedure.
Patients desiring future fertility should be appraised of potential risks of UAE, including the 7 in 1000 chance of premature ovarian failure and a similar risk of hysterectomy because of infection following UAE. It is possible that UAE will be shown to offer better overall results than myomectomy because of lack of recurrence, minimal adhesion formation, and the possibility of vaginal birth post procedure. Although pain and postoperative fever are common complaints after UAE, these side effects are minor when compared with the morbidity of surgical procedures. The risks associated with UAE seem to be less than the risks associated with either hysterectomy or myomectomy, with known morbidity of hemorrhage, adhesion formation, and infection. When failures are defined as patients who ultimately underwent hysterectomy (3%), who would not recommend the procedure to others (6%), and those whose TUV decreased by less than 10% (6%), a success rate of approximately 85% is reached.
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