A review of the results of uterine artery embolisation for the treatment of adenomyosis

Genital / Reproductive system female, Catheter arteriography, Embolisation, Embolism / Thrombosis, Outcomes Authors: L. Lyons, J. Clarke, A. G. Ryan DOI: 10.26044/ecr2025/C-25619 Learning objectives Uterine artery embolisation (UAE) is a defined treatment option for symptomatic uterine leiomyomas, however, its use to treat adenomyosis is not yet clearly defined in clinical practice. We wished to evaluate the impact of uterine artery embolisation on symptoms and quality of life (QoL) in patients with adenomyosis and to examine the impact of uterine artery embolisation on fertility.

Adenomyosis is a benign condition characterised by ectopic endometrial glands and stroma in the myometrium [Figure. 1 and Figure. 2] which can occur in isolation or concomitantly with fibroids. Adenomyosis can cause significant abnormal uterine bleeding, dysmenorrhea and chronic pelvic pain severely affecting quality of life. Historical treatment options typically comprised conversative medical management options involving non-steroidal antiflammatory drugs, the oral contraceptive pill and intrauterine devices. If these failed to manage the person’s symptoms, either asking the patient to live with their symptoms or referring... Findings and procedure details Significant improvement in symptoms in both short and long term follow up has been described, ranging from 83% in the short term versus 65% in the long term follow up [Figure 5 and Figure 6]. A systematic review by De Bruijn et al (2017), found that 2 of 34 studies reported pregnancies following UAE, 6 patients out of 99 becoming pregnant. There were no signs of utero-placental vascular insufficiency or abnormal uterine contractions observed during labour or postpartum. Complications of UAE in these cohorts described...

Uterine artery embolisation is an effective treatment alternative for women with symptomatic adenomyosis who wish to avoid hysterectomy. Although preservation of fertility has been reported, permanent amenorrhea has also been reported, thus uterine artery embolisation is currently recommended to women who have completed their families. Patients with severe symptoms uncontrolled with conservative measures who are being offered hysterectomy can be offered UAE as an alternative. In all cases, the patient must be warned about the potential impact on ovarian perfusion with resultant diminished fertility and... Personal information and conflict of interest L. Lyons: Nothing to disclose J. Clarke: Nothing to disclose A. G. Ryan: Nothing to disclose

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