{"paper_id":"2171ef52-01f5-457a-b494-02cffbf57091","body_text":"Abstract\nIntroduction\nLong-term results of uterine artery embolization (UAE) for adenomyosis are largely unknown. We assess long-term outcome of UAE in 40 women with adenomyosis.\nMaterials and methods\nBetween 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.\nResults\nDuring 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.\nConclusion\nIn 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.\nSimilar content being viewed by others\nReferences\nAzzir R (1989) Adenomyosis: current perspectives. Obstet Gynecol Clin N Am 16:221–235\nWood C (1988) Surgical and medical treatment of adenomyosis. Hum Reprod Update 4:323–336\nPelage JP, Jacob D, Fazel A et al (2005) Midterm results of uterine artery embolization for symptomatic adenomyosis: initial experience. Radiology 234:948–953\nBratby MJ, Walker WJ (2009) Uterine artery embolisation for symptomatic adenomyosis—mid-term results. Eur J Radiol 70:128–132\nLevgur M (2007) Therapeutic options for adenomyosis: a review. Arch Gynecol Obstet 276:1–15\nRabinovici J, Stewart EA (2006) New interventional techniques for adenomyosis. Best Pract Res Clin Obstet Gynaecol 20:617–636\nJha RC, Takahama J, Imaoka I et al (2003) Adenomyosis: MRI of the uterus treated with uterine artery embolization. AJR Am J Roentgenol 181:851–856\nSiskin GP, Tubulin ME, Stainken BF, Dowling K, Dolen EG (2001) Uterine artery embolization for the treatment of adenomyosis: clinical response and evaluation with MR imaging. AJR Am J Roentgenol 177:297–302\nLohle PN, De Vries J, Klazen CA, Boekkooi PF, Vervest HA, Smeets AJ et al (2007) Uterine artery embolization for symptomatic adenomyosis with or without uterine leiomyomas with the use of calibrated tris-acryl gelatin microspheres: midterm clinical and MR imaging follow-up. J Vasc Interv Radiol 18:835–841\nKim MD, Kim S, Kim NK et al (2006) Long-term results of uterine artery embolization for symptomatic adenomyosis. AJR Am J Roentgenol 186:855–864\nKitamura Y, Allison SJ, Jha RC et al (2006) MRI of adenomyosis: changes with uterine artery embolization. AJR Am J Roentgenol 186:855–864\nConflict of interest\nThe authors do not have any conflict of interest.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nSmeets, A.J., Nijenhuis, R.J., Boekkooi, P.F. et al. Long-Term Follow-up of Uterine Artery Embolization for Symptomatic Adenomyosis. Cardiovasc Intervent Radiol 35, 815–819 (2012). https://doi.org/10.1007/s00270-011-0203-1\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00270-011-0203-1","source_license":"CC0","license_restricted":false}