Failure of uterine fibroid embolization.

Abstract

OBJECTIVE:

To assess the outcomes of patients who underwent uterine fibroid embolization (UFE) and to evaluate factors associated with failure of UFE.

DESIGN:

Retrospective study.

SETTING:

University teaching hospital.

PATIENT(S):

Two hundred thirty-three consecutive patients who underwent UFE from November 1997 to February 2004.

INTERVENTION(S):

Uterine fibroid embolizations were performed by three interventional radiologists using 355-500-mu polyvinyl alcohol particles.

MAIN OUTCOME MEASURE(S):

Hysterectomy rate, myomectomy rate, and repeat UFE rate.

RESULT(S):

With a mean follow-up of 13 months, a total of 22 patients underwent surgery after UFE (9.4%); 16 had hysterectomies (6.9%), and 6 had myomectomies (2.6%). This included 3 patients who underwent repeat UFE and subsequently required surgical intervention. The mean (+/- SEM) time interval between UFE and subsequent treatment was 12.5 +/- 2.0 months. Among patients who required surgery, 13 (59.1%) presented with recurrent menorrhagia, and 5 (22.7%) complained of persistent abdominal pain. Histopathologic examination revealed concomitant findings of adenomyosis in 25% of hysterectomy specimens. Patients who failed UFE were more likely to have had a previous myomectomy (13% vs. 2.4%) and significant reduction in the uterine size 6 months after UFE (57.1% vs. 25.2%).

CONCLUSION(S):

The overall failure rate of UFE is 9.4%. Failure is mainly due to persistent menorrhagia and abdominal pain. Shrinkage of the uterus after UFE does not necessarily correlate with long-term success of UFE.

• Authors: Jack Y J Huang, Souzan Kafy, Alexandre Dugas, David Valenti, Togas Tulandi
• Journal: Fertility and sterility (Fertil Steril) Vol. 85 Issue 1 Pg. 30-5 (Jan 2006) ISSN: 1556-5653 [Electronic] United States
• PMID: 16412722 (Publication Type: Journal Article)

Chemical References

• Polyvinyl Alcohol

Topics

• Adult
• Embolization, Therapeutic (statistics & numerical data)
• Female
• Follow-Up Studies
• Humans
• Hysterectomy (statistics & numerical data)
• Leiomyoma (pathology, surgery, therapy)
• Menorrhagia
• Myometrium (pathology, surgery)
• Polyvinyl Alcohol
• Postoperative Complications
• Reoperation (statistics & numerical data)
• Retrospective Studies
• Treatment Failure
• Uterine Neoplasms (pathology, surgery, therapy)