Uterine Artery Embolization for Adenomyosis: A Review of Imaging, Techniques, Complications and Outcomes

In: Current Obstetrics and Gynecology Reports · 2023 · vol. 12(3) , pp. 186–197 · doi:10.1007/s13669-023-00367-6 · W4385791935
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Uterine artery embolization is a safe and successful treatment for symptomatic adenomyosis, offering a less invasive, uterine-sparing alternative to hysterectomy when conservative treatments fail.

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This review summarizes the literature on uterine artery embolization (UAE) for symptomatic pure adenomyosis, focusing on imaging considerations, embolization techniques, complications, and patient outcomes in people who have failed conservative medical therapy and want to avoid hysterectomy. Across the reviewed studies, UAE is reported to have low rates of major complications consistent with Society of Interventional Radiology (SIR) classifications and good symptom control/success rates, supporting it as a less invasive, uterine-sparing alternative. The paper’s caveat is that it is a narrative review of heterogeneous evidence rather than new controlled trial data. This paper is centrally about endometriosis-related pathology only insofar as it addresses adenomyosis—specifically, uterine artery embolization for symptomatic pure adenomyosis.

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Abstract

Purpose of Review This review aims to provide a comprehensive summary of the literature regarding the use of uterine artery embolization (UAE) in the treatment of pure adenomyosis and to document indications, results and complications for symptomatic patients who have failed conservative treatment and wish to avoid hysterectomy. Recent Findings There is growing evidence to support UAE as a safe and successful treatment for the treatment of symptomatic pure adenomyosis. Summary Pure adenomyosis has historically been treated with conservative pharmacological treatments including non-steroidal anti-inflammatories, hormonal contraceptive medications, and intrauterine devices. When such treatments have failed, hysterectomy has served as a definitive treatment for patients with symptomatic adenomyosis. However, the use of UAE to treat symptomatic adenomyosis has gained attraction in recent years as a less invasive and uterine sparing procedure, which may prove to be a suitable alternative for patients wishing to avoid hysterectomy. With the low rate of major complications in accordance with the Society of Interventional Radiology (SIR) classification and good success rates, UAE should be proposed as an alternative for patients who have failed medical therapy. Similar content being viewed by others

References

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Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Roop, S., Patel, S., Zhang, M. et al. Uterine Artery Embolization for Adenomyosis: A Review of Imaging, Techniques, Complications and Outcomes. Curr Obstet Gynecol Rep 12, 186–197 (2023). https://doi.org/10.1007/s13669-023-00367-6 Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s13669-023-00367-6

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