Uterine Artery Embolization in Treatment of Fibroid Uterus: A Case Series

Abstract

Background: Uterine artery embolization (UAE) for the management of fibroid uterus is now a widely used modality for management of fibroid uterus. It has an advantage over the gold standard options of hysterectomy of being minimally invasive, uterus conserving, and has faster recovery. We here discuss our experience of the use of UAE for treatment of fibroid uterus in seven patients who had UAE between 2015 and 2020. Materials and methods: Seven patients who had undergone uterine artery embolization for the treatment of fibroid uterus in our institute between 2015 and 2020 were selected and retrospectively inquired about their symptoms before the procedure and their outcome postprocedure was followed. Bilateral uterine arteries were embolized by interventional radiologist using polyvinyl alcohol (PVA) in all cases. Result: Out of the seven women who underwent UAE, six presented with a spectrum of menstrual complaints in the form of heavy menstrual bleeding and/or dysmenorrhea. One patient had pressure symptoms. Out of the six women with menstrual complaints, on follow-up, five of the six patients had symptomatic relief of heavy menstrual bleeding, whereas four of the six were symptomatically relieved of dysmenorrhea. Four of the seven patients had postprocedure radiological imaging which showed a comparative (10–50%) reduction in the size of the fibroids. None of the patients had other complications such as persistent postembolization syndrome, infection, or vaginal discharge. Conclusion: UAE as an alternative treatment modality for symptomatic fibroid uterus showed a good patient satisfaction with most of the patients being relieved of their symptoms in our study. However, long-term outcomes in the form of fertility issues, recurrence of symptoms, and need for reintervention could not be assessed in the study. Clinical significance: UAE as a treatment modality was met with high-level patient satisfaction in our study group. There were minimal complications associated with the procedure. Longer follow-up will be required to comment on the effect of UAE on fertility outcome.