Failure of uterine fibroid embolization

Jack Y J Huang, Huang JY, Kafy S, Souzan Kafy, Alexandre Dugas, Dugas A, David Valenti, Valenti D, Togas Tulandi, Tulandi T
Fertility and sterility · 2006 · vol. 85(1) , pp. 30–35 · doi:10.1016/j.fertnstert.2005.03.091 · PMID:16412722 · W2040965737
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This paper details cases where uterine fibroid embolization did not achieve the desired outcome for patients.

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Abstract

OBJECTIVE: To assess the outcomes of patients who underwent uterine fibroid embolization (UFE) and to evaluate factors associated with failure of UFE. DESIGN: Retrospective study. SETTING: University teaching hospital. PATIENT(S): Two hundred thirty-three consecutive patients who underwent UFE from November 1997 to February 2004. INTERVENTION(S): Uterine fibroid embolizations were performed by three interventional radiologists using 355-500-mu polyvinyl alcohol particles. MAIN OUTCOME MEASURE(S): Hysterectomy rate, myomectomy rate, and repeat UFE rate. RESULT(S): With a mean follow-up of 13 months, a total of 22 patients underwent surgery after UFE (9.4%); 16 had hysterectomies (6.9%), and 6 had myomectomies (2.6%). This included 3 patients who underwent repeat UFE and subsequently required surgical intervention. The mean (+/- SEM) time interval between UFE and subsequent treatment was 12.5 +/- 2.0 months. Among patients who required surgery, 13 (59.1%) presented with recurrent menorrhagia, and 5 (22.7%) complained of persistent abdominal pain. Histopathologic examination revealed concomitant findings of adenomyosis in 25% of hysterectomy specimens. Patients who failed UFE were more likely to have had a previous myomectomy (13% vs. 2.4%) and significant reduction in the uterine size 6 months after UFE (57.1% vs. 25.2%). CONCLUSION(S): The overall failure rate of UFE is 9.4%. Failure is mainly due to persistent menorrhagia and abdominal pain. Shrinkage of the uterus after UFE does not necessarily correlate with long-term success of UFE.

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MeSH descriptors

Embolization, Therapeutic Embolization, Therapeutic Embolization, Therapeutic Leiomyoma Uterine Neoplasms Adult Adult Female Female Follow-Up Studies Follow-Up Studies Humans Humans Hysterectomy Hysterectomy Hysterectomy Leiomyoma Leiomyoma Leiomyoma Leiomyoma

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