Abstract:
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Purpose: To evaluate mid-term results of uterine artery embolization in the
management of menorrhagia due to adenomyosis.
Methods and Materials: Eighteen women (mean age 44.4 years, range 36-52) with
menorrhagia related to adenomyosis underwent bilateral uterine artery
embolization. The diagnosis of diffuse adenomyosis was based on enlarged
junctionnal zone and myometrial cysts with ultrasound or MRl with no evidence
of associated fibroids. Focal adenomyosis was diagnosed if there was a
circumscribed nodular lesion mimicking intramural fibroid. Uterine artery
embolization was performed using PVA particles, trisacryl calibrated
microspheres and/or gelatin sponge pledgets. Clinical evaluation was made at
regular intervals to assess patient outcome. Follow-up ultrasound or MRI was
performed 6 months after embolization to assess uterine volume reduction.
Results: Fourteen women had diffuse adenomyosis and four women had focal
adenomyosis. Bilateral uterine artery embolization was performed in all but one
woman. At 6 months, 16/18 women (89%) reported significant improvement of their
symptoms. Follow-up imaging at 6 months demonstrated a slight decrease in
uterine volume in 17/18 women (94%). At a mean follow-up of 29 months (12-74
months), only 5/18 women (39%) were still significantly improved. Five women
have been treated by hysterectomy for recurrence of symptoms.
Conclusion: Bilateral uterine artery embolization provides initial symptomatic
relief in patients with adenomyosis and menorrhagia. However, long-term
evaluation suggest a higher rate of recurrence than with uterine artery embolization
for fibroids. (J.P. is a consultant and received grants from Biosphere Medical,
Boston Scientific, and Biocompatibles.)
Questions about this event email: jean-pierre.pelage@apr.ap-hop-paris.fr
Pelage MD, J,
Mid-term Results of Uterine Artery Embolization for Symptomatic Adenomyosis. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3106049.html