[Intermediate and long term clinical effects of uterine arterial embolization in treatment of adenomyosis].

OBJECTIVE: To assess the intermediate and long term clinical effectiveness of uterine arterial embolization (UAE) in treatment of adenomyosis. METHODS: The standard UAE was performed in 189 patients with adenomyosis in our hospital from Jun 1999 to Jun 2004. The fresh gelfoam particles or polyvinyl alcohol particles (PVA) or sodium alginate microspheres for vascular embolization (KMG) mixed with antibiotics were used to embolize the arteries. The degree of dysmenorrhea and amount of menorrhea after the operation were investigated. RESULTS: (1) The number of the cases completely followed up was 168, with a ratio of 88.9%, and a follow-up time of (50 +/- 15) months. (2) The symptom of dysmenorrhea: in all 168 patients, 159 had dysmenorrhea before the operation. Clinical effectiveness was observed in 82.4% (131/159) of patients after the operation, but in 17.6% (28/159) of patients there was no clinical effectiveness, and in 5.0% (8/159) of patients the dysmenorrhea recurred after the operation. (3) The clinical effectiveness between the patients with adenomyosis with and without myoma or between the patients with local and diffuse adenomyosis had no significant difference (P > 0.05). (4) The amount of menorrhea: in the 93 patients with hypermenorrhea, the amount of menorrhea returned to normal in 83.9% (78/93), oligomenorrhea occurred in 10.8% (10/93), the menorrhea of 2 patients was rare, transient amenorrhea occurred in one case, and the amount of menorrhea did not change in two patients. Among the 74 patients with normal menorrhea, the menorrhea amount did not change in 77.0% (57/74), oligomenorrhea occurred in 20.3% (15/74), uterine amenorrhea occurred in two patients. The menorrhea amount of one patient with oligomenorrhea returned to normal after the UAE therapy. (5) Nine patients accepted hysterectomy due to reoccurrence of dysmenorrhea or ineffectiveness or hypermenorrhea. CONCLUSION: UAE has a good intermediate and long term effectiveness in treatment of adenomyosis.