Uterine Artery Embolization as an Alternative Therapeutic Option in Adenomyosis: An Observational Retrospective Single-Center Study

Melinda-Ildiko Mitranovici, Dan Costăchescu, Dan Dumitrascu-Biris, Liviu Moraru, Laura Georgiana Caravia, Laura Caravia, Florin Bobirca, Florin Bobîrcă, Elena Bernad, Viviana Ivan, Adrian Apostol, Ioana Cristina Rotar, Lucian Marginean, Lucian Mărginean
Journal of clinical medicine · 2025 · vol. 14(11) , pp. 3788 · doi:10.3390/jcm14113788 · PMID:40507550 · PMC12155893 · W4410817982
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study evaluated uterine artery embolization (UAE) against hysterectomy for adenomyosis, finding both improved quality of life, with UAE reducing pain and hysterectomy completely stopping bleeding.

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Abstract

Adenomyosis is a benign gynecologic disease that mainly affects women aged 30-50 years old. Background: This pathology is characterized by glands and stroma of the endometrium that enter the myometrium and is confirmed through histopathological examination after hysterectomy. Transvaginal ultrasound is the most accepted imaging approach for the diagnosis and classification of adenomyosis. Existing medical treatments are not curative and are associated with several side effects. Uterine artery embolization is an alternative treatment for controlling the symptoms of adenomyosis with less trauma while preserving the uterus. Methods: The aim of our study was to observe the utility of uterine artery embolization (UAE) compared to hysterectomy in specific cases of adenomyosis. A retrospective cohort study was carried out between February 2024 and April 2025. We included 52 patients in our study: 27 opted for hysterectomy, while the other 25 chose to receive uterine artery embolization between January 2017 and December 2018. Clinical follow-up was assessed using a questionnaire regarding symptomatic changes in menorrhagia, pelvic pain, and quality of life before and after the surgical procedure. Statistical analyses were performed. Results: Patients opted for hysterectomy in cases of severe abnormal uterine bleeding before surgery that severely affected quality of life (p < 0.03 and p < 0.001). After surgery, pelvic pain improved for women who underwent UAE, but patients also reported no pelvic pain after hysterectomy. Furthermore, mild to moderate abnormal uterine bleeding was reported in cases of UAE, and bleeding stopped completely for women who had their uterus removed (p < 0.001). Quality of life improved for both groups and was reported as being good after the interventions. Conclusions: Embolization remains an alternative therapeutic option in adenomyosis but not a substitute for hysterectomy. This was concluded based on a case-by-case evaluation, depending on the desire for pregnancy, with a focus on improved clinical outcomes.

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Outcome instruments

VAS-pain MUSA

Condition tags

adenomyosis

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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