Petri Sipola MD, Presenter: Nothing to Disclose

Yawu Liu MD, Abstract Co-Author: Nothing to Disclose

Ritva Liisa Vanninen MD, Abstract Co-Author: Nothing to Disclose

Maritta Hippeläinen, Abstract Co-Author: Nothing to Disclose

Hannu Ilmari Manninen MD, Abstract Co-Author: Nothing to Disclose

To evaluate the role of hyperacute myometrial ischemia and fibroid necrosis in the pathogenesis of post-procedural pain after uterine artery embolization (UAE).

Twenty-nine patients (age range, 48 - 57 years) were studied before, 24 hours, and 6 months after UAE with magnetic resonance imaging (MRI). Maximal pain on the hospital ward was recorded on a structured scale from 0 to 10. Bilateral UAE was performed with selective approach with 550 -700 μm calibrated microsphere particles. Dominant fibroid volume before and 6 months after embolization was measured by MRI. Poor or no contrast enhancement of myometrium at MRI imaging performed 24 ± 3 (mean ± 1 stanrard deviation) hours after UAE was considered to represent uterine ischemia.

Myometrial ischemia was found in 13 patients (44%). No statistically significant difference in preoperative fibroid size or fibroid shrinkage rate at 6 months between patients with pain scale 4-10 and in patients with pain scale 0-3 was observed. A mean maximal pain 24 hours after embolization was higher in patients with myometrial ischemia than in patients without ischemia (6.0 ± 2.7 vs 3.9 ± 3.0; P=.048).

Post-procedural pain does not predict fibroid shrinkage rate in 6 months follow up. Post-procedular pain is associated with the presence of hyperacute myometrial ischemia.

Myometrial ischemia with highly variable extent is common after UAE. Uterine ischemia may be one factor causing post-procedural pain after UAE.

Sipola, P, Liu, Y, Vanninen, R, Hippeläinen, M, Manninen, H, Post-procedural Pain after Uterine Artery Embolization is Associated with the Presence of Hyperacute Myometrial Ischemia.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4433753.html