Efficacy of uterine artery embolisation for treatment of symptomatic fibroids and adenomyosis - An interim report on an Australian experience

摘要

Background: Uterine artery embolisation (UAE) has been widely described internationally, however there is a paucity of data reported from Australia. Aim: To conduct a local audit on the efficacy and safety of UAE treating symptomatic fibroids and adenomyosis. Methods: Clinical data of 76 consecutive UAEs were reviewed. Degree of fibroid-related symptoms before embolisation and at follow-up visits were compared. Procedural and subsequent complications were recorded. Uterine and fibroid volumes were measured on MRI at baseline and six months post-UAE. Results: Seventy-six UAEs were performed in 75 women. Fifty-nine women had follow-up duration of more than six months, and one woman was lost to follow-up. Clinical success was 93% overall (n = 59) and 96% for menorrhagia (n = 49). For dysmenorrhoea (n = 36), 89% of women had at least some improvement, 75% had significant improvement and 56% had resolution of pain. For urinary symptoms (n = 32), 97% of women had at least some improvement and 50% had resolution of all urinary symptoms. Adenomyosis was found in 17 (29%) women treated. The primary success rate was 96%, and secondary success rate (after repeat UAE) was 100%. MRI showed 50% uterine volume reduction and 60% dominant fibroid volume reduction. There were no significant procedural-related acute complications. There were three possible cases of endometritis, two managed conservatively and one required hysterectomy. Conclusions: This audit, based on local Australian experience, has confirmed that UAE is a safe and highly effective treatment for women with symptomatic fibroids and/or adenomyosis.