Vera Fröling, Abstract Co-Author: Nothing to Disclose

Christian Scheurig-Münkler MD, Abstract Co-Author: Nothing to Disclose

Bernd K. Hamm MD, Abstract Co-Author: Research Consultant, Bayer AG Research Consultant, Toshiba Corporation Stockholder, Siemens AG Stockholder, General Electric Company Stockholder, Biomed Research grant, Toshiba Corporation Research grant, Koninklijke Philips Electronics NV Research grant, Siemens AG Research grant, General Electric Company Research grant, Elbit Medical Imaging Ltd Research grant, Bayer AG Research grant, Guerbet AG Research grant, Bracco Group Research grant, B. Braun Research grant, Knauth Research grant, Boston Group Equipment support, Elbit Medical Imaging Ltd Investigator, Copenhagen Malmo Contrast AB, Lund, Sweden

Thomas J. Kroencke MD, Presenter: Consultant, Terumo Corporation, Tokyo, Japan Consultant, BioSphere Medical, Inc, Rockland, MA

The purpose of this retrospective study was to evaluate the long-term clinical outcome of women undergoing uterine artery embolization (UAE) for adenomyosis with or without uterine fibroids

Forty pre-menopausal women aged 39 to 56 years (Median: 46.5 years) with menorrhagia and/or dysmenorrhea and magnetic resonance (MR) imaging findings consistent with adenomyosis of the uterus underwent UAE as an alternative to hysterectomy. Clinical symptoms were assessed at baseline on a yes/no basis and at follow-up by a questionnaire using the categories: resolved, markedly improved, improved, unchanged, worsened, markedly worsened. The Uterine Fibroid Symptom and Quality of Life (UFS-QoL) Questionnaire was used to assess residual symptom severity and health related quality-of-life (HRQOL). All treatments after UAE were recorded. Clinical failure was defined as no improvement or 2nd invasive therapy to control symptoms after UAE. Results were stratified based on the extent of adenomyosis at baseline MR imaging. Kaplan Meier analysis was performed to determine freedom from clinical failure. Associated log rank was used to test differences among groups.

Patients were followed for a median of 40.5 months (range: 5-102 months). UAE lead to clinical improvement in 29/40 (73%) of patients. 11 patients had a clinical failure. 10 Patients underwent a 2nd intervention (hysterectomy, n=9, repetitive D&C, n =1). Based on MR imaging three different groups could be identified: pure adenomyosis (n=13), adenomyosis with leiomyoma predominance (n=10), or adenomyosis predominance (n=17). Within the group of patients with leiomyoma predominance none had a clinical failure. This difference was significant (p=0.028) compared to patients with adenomyosis predominance and almost reached significance in comparison to the group with pure adenomyosis (p=0.079). After UAE residual symptom severity was highest and HRQOL lowest for women with pure adenomyosis.

UAE is clinical effective at long-term in the majority of patients with adenomyosis. Symptomatic control and improvement in quality-of-life was highest in patients with adenomyosis but predominant uterine leiomyomata. Clinical failure and hysterectomy occurs more often in patients with predominant adenomyosis.

Provide long-term results of an interventional radiological treatment of adenomyosis of the uterus

Fröling, V, Scheurig-Münkler, C, Hamm, B, Kroencke, T, Uterine Artery Embolisation to Treat Menorrhagia and Dysmenorrhea Related to Adenomyosis with or without Uterine Leiomyomata: Long-term Symptom Control, Frequency of Reinterventions and Quality-of-Life.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9007205.html