Outcomes in Adenomyosis Treated with Uterine Artery Embolization Are Associated with Lesion Vascularity: A Long-Term Follow-Up Study of 252 Cases

Jing Zhou, Li He, Ping Liu, Hui Duan, Hanze Zhang, Weili Li, Shipeng Gong, Guidong Su, Chunlin Chen
PloS one · 2016 · vol. 11(11) , pp. e0165610 · doi:10.1371/journal.pone.0165610 · PMID:27806072 · W2547648275
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Uterine artery embolization effectively treated adenomyosis symptoms long-term, with outcomes significantly correlated with lesion vascularity.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This single-institute retrospective study evaluated 252 adenomyosis patients treated with uterine artery embolization (UAE), using digital subtraction angiography (DSA) to classify uterine blood supply symmetry (equal vs unequal left-right contribution) and lesion-site vascularity (hypervascular, isovascular, hypovascular). Patients were followed for up to 5 years, and dysmenorrhea and menorrhagia improvements were defined by predefined reductions in symptom grades; overall dysmenorrhea improvement was 74.0% (12 months) and 70.4% (5 years), while menorrhagia improvement was 70.9% (12 months) and 68.8% (5 years). Blood supply symmetry was not associated with significantly different symptom improvement, but lesion vascularity was: dysmenorrhea improvement differed across vascularity categories at both 12 months (p=0.002) and 5 years (p=0.005), and menorrhagia improvement differed at 12 months (p=0.024) with a borderline association at 5 years (p=0.052). The paper’s main limitation is that it is retrospective, single-institute, and relies on symptom-grade thresholds and follow-up completeness rather than a randomized design. This paper is centrally about adenomyosis — it links UAE outcomes to adenomyosis lesion vascularity and uterine arterial blood-supply patterns.

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Abstract

PURPOSE: To study the therapeutic effects of uterine artery embolization (UAE) on adenomyosis and to investigate the association between uterine blood supply and artery embolization treatment outcomes. METHODS: Using digital subtraction angiography (DSA) imaging data, we retrospectively evaluated the vascular features of 252 adenomyosis patients treated with UAE. The cases were classified based on the equality of uterine blood supply (equal and unequal subgroups) and the degree of vascularity at the adenomyosis lesion site (hypervascular, isovascular and hypovascular subgroups). Patients were followed-up for 5 years after UAE. Improvements in dysmenorrhea and menorrhagia were evaluated based on the relief of the patients' symptoms. The improvement rates among the different subgroups were analyzed and compared. RESULTS: The improvement rates of dysmenorrhea and menorrhagia were 74.0% and 70.9%, respectively, at the short-term (12-month) follow-up and 70.4% and 68.8%, respectively, at the long-term (5-year) follow-up. No statistically significant differences were observed in the improvement rates for dysmenorrhea or menorrhagia between the equal and unequal blood supply subgroups at either the short- or long-term follow-up. The improvement rates for dysmenorrhea among the hypervascular, isovascular and hypovascular subgroups were 86.5%, 71.8% and 58.8%, respectively, at the short-term follow-up (p = 0.002) and 83.6%, 67.3% and 52.8%, respectively, at the long-term follow-up (p = 0.005). The improvement rates for menorrhagia in the hypervascular, isovascular and hypovascular subgroups were 81.0%, 68.3% and 60.7%, respectively, at the short-term follow-up (p = 0.024) and 79.4%, 61.4% and 62.2%, respectively, at the long-term follow-up (p = 0.052). CONCLUSION: UAE is effective in treating patients with adenomyosis in both the short and long term. The outcomes of patients with adenomyosis were significantly correlated with lesion vascularity.

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Condition tags

mesh:D004412adenomyosisdysmenorrhea

MeSH descriptors

Adenomyosis Dysmenorrhea Menorrhagia Uterine Artery Embolization Adenomyosis Adenomyosis Adenomyosis Adult Angiography, Digital Subtraction Dysmenorrhea Dysmenorrhea Female Follow-Up Studies Humans Menorrhagia Menorrhagia Middle Aged Retrospective Studies Treatment Outcome Uterine Artery Embolization

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