Uterine Artery Embolization to Treat Uterine Adenomyosis with or without Uterine Leiomyomata: Results of Symptom Control and Health-Related Quality of Life 40 Months after Treatment

• Published in: Cardiovascular and interventional radiology 2012-06, Vol.35 (3), p.523-529
• Main Authors: Froeling, V., Scheurig-Muenkler, C., Hamm, B., Kroencke, T. J.
• Format: Article
• Language: English
• Subjects: Adult; ADULTS; AGE GROUPS; AGED ADULTS; ANIMALS; ARTERIES; BLOOD VESSELS; BODY; Cardiology; CARDIOVASCULAR SYSTEM; Chi-Square Distribution; Clinical Investigation; CONTROL; DIAGNOSTIC TECHNIQUES; Dilatation and Curettage; DISEASES; ELDERLY PEOPLE; Embolization, Therapeutic - methods; Endometriosis - complications; Endometriosis - therapy; Female; FEMALES; HUMAN POPULATIONS; Humans; Hysterectomy; Imaging; Kaplan-Meier Estimate; Leiomyoma - complications; Leiomyoma - therapy; Magnetic Resonance Imaging; MAMMALS; MAN; MEDICINE; Medicine & Public Health; Microspheres; Middle Aged; MINORITY GROUPS; NMR IMAGING; Nuclear Medicine; ORGANS; PATIENTS; Polyvinyl Alcohol - therapeutic use; POPULATIONS; PRIMATES; Quality of Life; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; STANDARD OF LIVING; Statistics, Nonparametric; Surveys and Questionnaires; SYMPTOMS; THERAPY; Treatment Outcome; Ultrasound; Uterine Neoplasms - complications; Uterine Neoplasms - therapy; VERTEBRATES; WOMEN
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-011-0254-3

Purpose To evaluate the clinical outcome for uterine adenomyosis with or without uterine leiomyomata 40 months after uterine artery embolization (UAE). Methods Forty women aged 39–56 years (median 46 years) with symptomatic uterine adenomyosis and magnetic resonance imaging findings of uterine adenomyosis with or without combined uterine leiomyomata underwent UAE. Self-perceived changes in clinical symptoms were assessed, and residual symptom severity and health-related quality of life (HRQOL) after UAE were evaluated. Clinical failure was defined as no symptomatic improvement or second invasive therapy after UAE. Results were stratified by the extent of uterine adenomyosis at baseline magnetic resonance imaging. Results Patients were followed for a median of 40 months (range 5–102 months). UAE led to symptomatic control after UAE in 29 (72.5%) of 40 patients while 11 women underwent hysterectomy ( n  = 10) or dilatation and curettage ( n  = 1) for therapy failure. No significant difference between women with pure uterine adenoymosis and women with uterine adenomyosis combined with uterine leiomyomata was observed. Best results were shown for UAE in uterine adenomyosis with uterine leiomyomata predominance as opposed to predominant uterine adenomyosis with minor fibroid disease (clinical failure 0% vs. 31.5%, P  = 0.058). Throughout the study group, HRQOL score values increased and symptom severity scores decreased after UAE. Least improvement was noted for women with pure adenomyosis. Conclusions UAE is clinically effective in the long term in most women with uterine adenomyosis. Symptomatic control and HRQOL were highest in patients with combined disease of uterine adenomyosis but leiomyomata predominance.