The Efficacy of Uterine Artery Embolization in the Treatment of Adenomyosis by DSA Guided Local Methotrexate Perfusion

Objective: To investigate the clinical efficacy and safety of uterine artery embolization in the treatment of adenomyosis by perioperative vascular digital subtraction angiography( DSA) guided local methotrexate perfusion. Method: 100 patients with adenomyosis were collected. After DSA guided intubation,50mg methotrexate was injected. The patients were reviewed after treatment for 3months,6 months and menstrual clean for 3-7 days. The menstrual cycle,menstrual quantity,period pain,uterine size and uterine artery blood flow resistance index( RI) and sex hormone,follicle-stimulating hormone( FSH),luteinizing hormone( LH),estradiol( E2),testosterone( T),progesterone( P),prolactin( PHL) change,intraoperative and postoperative complications were observed. Result: After treatment for 3 months and 6 months,the sanitary napkin counting scores,menstrual cycle,menstrual cramps,uterine volume shrinking,RI value was significantly decreased. There was significantly changes after treatment than before treatment( P 0.05). After treatment FSH,LH,E2,T,P,PHL was no obvious changes( P 0.05). The incidence of postoperative abdominal pain was 100%. The fever and malignant vomiting was rare. Conclusion: Uterine artery embolization in the treatment of adenomyosis by DSA guided local methotrexate perfusion can significantly improve the clinical symptoms.