Long-Term Follow-up of Uterine Artery Embolization for Symptomatic Adenomyosis

A J Smeets, Albert J. Smeets, Smeets AJ, Nijenhuis RJ, Robbert J. Nijenhuis, R J Nijenhuis, Peter F. Boekkooi, Boekkooi PF, P F Boekkooi, Harry A.M. Vervest, Vervest HA, H A M Vervest, W J van Rooij, van Rooij WJ, Paul N.M. Lohle, P. N. M. Lohle, Lohle PN
Cardiovascular and interventional radiology · 2011 · vol. 35(4) , pp. 815–819 · doi:10.1007/s00270-011-0203-1 · PMID:21717251 · W2046280067
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-14 ⓘ

Uterine artery embolization in 40 women with adenomyosis resulted in long-term uterus preservation for most, with a thicker junction zone predicting hysterectomy.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-06 · read from full text ⓘ

This study followed 40 consecutive women with symptomatic adenomyosis treated with uterine artery embolization (UAE) between 1999 and 2006, assessing junction zone thickness by MRI at baseline and 3 months and capturing long-term symptoms and adverse events using the UFS-QoL questionnaire after a mean follow-up of 65 months. During follow-up, 7/40 (18%) underwent hysterectomy, and among these, junction zone thickness was significantly greater at both baseline and 3-month follow-up, whereas most women with a preserved uterus were asymptomatic. Four patients with preserved uterus had substantial residual symptoms and lower overall quality-of-life scores, and there was no relation between clinical outcome and the presence of additional fibroids. This paper is centrally about endometriosis and/or adenomyosis — it is specifically about adenomyosis treated with UAE and its long-term outcomes, including MRI-based predictors of hysterectomy.

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Abstract

IntroductionLong-term results of uterine artery embolization (UAE) for adenomyosis are largely unknown. We assess long-term outcome of UAE in 40 women with adenomyosis.Materials and methodsBetween 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.ResultsDuring 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.ConclusionIn 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.
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Abstract

Introduction Long-term results of uterine artery embolization (UAE) for adenomyosis are largely unknown. We assess long-term outcome of UAE in 40 women with adenomyosis.

Materials and methods

Between 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.

Results

During 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.

Conclusion

In 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. Similar content being viewed by others

References

Azzir R (1989) Adenomyosis: current perspectives. Obstet Gynecol Clin N Am 16:221–235 Wood C (1988) Surgical and medical treatment of adenomyosis. Hum Reprod Update 4:323–336 Pelage JP, Jacob D, Fazel A et al (2005) Midterm results of uterine artery embolization for symptomatic adenomyosis: initial experience. Radiology 234:948–953 Bratby MJ, Walker WJ (2009) Uterine artery embolisation for symptomatic adenomyosis—mid-term results. Eur J Radiol 70:128–132 Levgur M (2007) Therapeutic options for adenomyosis: a review. Arch Gynecol Obstet 276:1–15 Rabinovici J, Stewart EA (2006) New interventional techniques for adenomyosis. Best Pract Res Clin Obstet Gynaecol 20:617–636 Jha 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 Siskin 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 Lohle 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 Kim 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 Kitamura Y, Allison SJ, Jha RC et al (2006) MRI of adenomyosis: changes with uterine artery embolization. AJR Am J Roentgenol 186:855–864 Conflict of interest The authors do not have any conflict of interest. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Smeets, 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 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00270-011-0203-1

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adenomyosis

MeSH descriptors

Adenomyosis Leiomyoma Uterine Artery Embolization Adenomyosis Adenomyosis Adult Chi-Square Distribution Female Follow-Up Studies Humans Hysterectomy Leiomyoma Magnetic Resonance Imaging Middle Aged Quality of Life Retrospective Studies Surveys and Questionnaires Treatment Outcome Uterine Artery Embolization

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