Uterine Artery Embolization for the Treatment of Adenomyosis

Ziele: The constellation of symptoms of uterine fibroids and adenomyosis are similar. Based on positive results reported as a treatment for uterine fibroids, uterine artery embolization (UAE) has been investigated as a possible therapeutic tool to treat adenomyosis. Methode: All publications retrievable through Medline, Embase or Pubmed with keywords such as adenomyosis, uterine artery embolization, uterine fibroid embolization, adenomyosis therapy and adenomyosis treatment were included in this report. All studies written or abstracted in English were utilized. Data available from reports from 1999 through august 2009 were evaluated. Level of evidence was classified as Level I, II, or III with 3 subcategories in Level II based on the quality of evidence developed by the United States Preventive Services Task Force (USPSTF) Ergebnis: UAE was performed in and follow-up data is available from 314 affected women. The included 16 studies report on outcomes from 3 to 54 patients per study. Improvements in symptoms largely related to bleeding, pain and bulk related discomfort were reported by 245 (78%) patients. The median follow-up for the collective group is 19.6 months. The studies outlined herein mostly provide level II-2 through level III type of evidence. Some better designed trials offer level II-1 evidence as defined by the USPSTF. Schlussfolgerung: UAE as treatment for adenomyosis shows clear trends of clinical and symptomatic improvements. Long-term data are needed to verify initial results and randomized, controlled trials are essential to validate current research data.