{"paper_id":"9bb5836c-87dd-45b5-8bfa-4ce2b25cc414","body_text":"ECR 2010 / C-2074\nUAE for the treatment of symptomatic adenomyosis\nCongress:\nECR 2010\nPoster Number:\nC-2074\nType:\nScientific Exhibit\nKeywords:\nInterventional vascular, Vascular, Percutaneous\nAuthors:\nV. D. Souftas, P. Tsikouras, M. Mantatzis, E. Astrinakis, S. Foutzitzi, V. Liberis, P. Prassopoulos; Alexandroupolis/GR\nDOI:\n10.1594/ecr2010/C-2074\nPurpose\nAdenomyosis is a common disease with an incidence of 5-7% in surgical series, affecting primarily premenopausal women. It is characterized by the presence of heterotopic endometrial glands and stroma in the myometrium, associated with adjacent myometrial hyperplasia. Epithelial and stromal elements are situated at least 2.5mm beyond the endometrial-myometrial junction [1]. Adenomyosis may be either diffuse or focal (adenomyoma). Coexisting myomas and asymmetric wall involvement are common with the posterior uteral wall being mostly affected [2]. Menorrhagia and dysmenorrhea are the major symptoms of adenomyosis,...\nMethods and Materials\nThe study comprises fifteen consecutive symptomatic women (age 37-55y.o., mean 46.3y) that were presented with dysmenorrhea, dyspareunea, pelvic discomfort, menorrhagia-metrorrhagia and anemia. Diffuse adenomyosis (n=5), focal adenomyosis (n=2), coexisting diffuse and focal adenomyosis (n=8) were diagnosed based on imaging findings (US, MRI) and clinical evaluation. Three patients had also myomatosis (Figure 1). Inclusion criteria were also based on the fact that all the patients desired to keep the uterus and were reluctant to a more invasive and amputating treatment such as hysterectomy (Figure 2). Patients...\nResults\nTechnically successful embolization of both uterine arteries was achieved in all cases. All patients suffered from severe post-procedural pain lasting 24h, which was treated with analgesics. No other immediate complication was noted.A major complication occurred in one case (6%), 45 days post-embolization. This complication consisted of partial vaginal expulsion of necrosed portions of focal adenomyosis and sepsis. The necrosed tissues were surgically resected, while the uterus was preserved (Figure 1, Figure 2). On the follow up 6 months post-UAE, a significant decrease of the uterine...\nConclusion\nThe short-term and mid-term results of our study are encouraging. Thus, UAE seems to be a technically efficient, non-amputating treatment option for adenomyosis, offering a significant regression of the patients’ symptoms. The procedure is well tolerated by using analgesics, while the risk of significant complications is low. Long-term results as well as the need for re-embolization are currently under evaluation.Treatment of symptomatic adenomyosis with bilateral transcatheter embolization of the uterine arteries may offer an effective treatment option when conservative treatment fails.\nReferences\nWang PH, Su WH, Sheu BC, Liu WM. Adenomyosis and its variance: adenomyoma and female fertility. Taiwan J Obstet Gynecol. 2009;48:232-8Levgur M. Diagnosis of adenomyosis. J Reprod Med 2007;52:177–93McElin TW, Bird CC. Adenomyosis of the uterus. Obstet Gynecol Annu. 1974;3:425-41Levgur M. Diagnosis of adenomyosis: a review. J Reprod Med. 2007;52:177-93Tamai K, Togashi K, Ito T, Morisawa N, Fujiwara T, Koyama T. MR imaging findings of adenomyosis: correlation with histopathologic features and diagnostic pitfalls. Radiographics 2005;25:21–40Jha RC, Takahama J, Imaoka I, Korangy SJ, Spies JB, Cooper...","source_license":"CC0","license_restricted":false}