Midterm follow up results of uterine artery embolization for the treatment of uterine adenomyosis and myomas

Purpose: The purpose of this study is to evaluate the natural course of uterine artery embolization for the treatment of uterine adenomyosis and myomas during the midterm follow up. Materials and methods: One hundred and sixty women (age range: 25–55 years; mean age: 40 years) having symptomatic (dysmenorrhea, menorrhagia, pressure symptoms) uterine adenomyosis or myoma were recruited in this prospective study. Technically or clinically failed cases and lost patients during the follow up period were excluded. We performed embolization with coaxial technique via right femoral route, PVA particles (250–710 mm), and gelfoam. Detailed clinical and sonographic follow up were obtained at a week for 143 patients, at 6 months for 80 patients, at 1 year for 24 patients, at 18 months for 25 patients, and at 2 years for 31 patients. Results: The volumes of uterus and myomas were progressively reduced in all patients until 1 year, and then stable during the next 1 year. Mean volume reduction of uterus and myomas were 43.2 and 70.2%, respectively. The peak systolic velocities of uterine arteries were markedly decreased at a week, recovered at 6 months, and then stable until 2 years after the procedure. Resistive indexes of uterine arteries were abruptly increased at a week, recovered at 6 months, and then stable thereafter. The flow of uterine arteries did not show the full recovery of initial levels. Conclusion: Uterine artery embolization for the treatment of uterine adenomyosis and myomas is minimally invasive procedure with stable natural course during the midterm follow up.