Uterine Artery Embolization for Treatment of Adenomyosis: Midterm Results

[Objective] To investigate the clinical response of uterine artery embolization (UAE) for the treatment of adenomyosis and complications of UAE. [Methods] UAE was performed in 17 cases with adenomyosis. The embolic agent was polyvinyl alcohol particles (PVA). The degree of dysmenorrhea and the menstrual blood volume were evaluated before and after embolization. The uterus and the lesion were examined with transvaginal color Doppler energy sonography (TVCDES) before UAE and the 1st day, 5th day, the day after the menses was over after UAE. All patients had been followed up from 5 to 44 months (average 21 months). [Results] There were dysmenorrhea and menorrhagia in 17 patients. The dysmenorrhea and menorrhagia were relieved in 15/17 (88%) and was not changed in 2/17 (12%). The TVCDES showed that there were rare or no blood flow signal in lesion on the day after UAE. But the blood flow signal had been being recovery and rich in myometrium and lesions since the 5th day after UAE. The blood flow signals were rich in lesion before embolization. But the blood flow signals were not detected in lesion and myometrium on the day of embolization. The blood flow signals were detected in lesion and myometrium on the 5th day later after embolization and from then on. The volume of uterus and lesion started to shrink 1 month later after embolization. The shrinkage of them reached to maximum three months later and stabilized from then on. The fever occurred in 13 patients. The vaginal bleeding occurred in 12 patients. Two patients were pregnant and gave birth successfully after embolization. [Conclusion] Uterine artery embolization for adenomyosis is a new, less-traumatic, safe, effective, less-complications and short-time recovery therapy. Its midterm effects are satisfied. TVCDES can evaluate the effectiveness and estimate prognosis of UAE for adenomyosis. It is helpful in selecting the indications for UAE.