Long‐term durability of uterine artery embolisation for treatment of symptomatic adenomyosis

Background Failing conservative therapies, uterine artery embolisation (UAE) has been proposed as a uterine‐sparing option for treatment of symptomatic adenomyosis. UAE appears effective at short‐term; however long‐term durability is less well established. Aims To evaluate the long‐term clinical eff...

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Published in:Australian & New Zealand journal of obstetrics & gynaecology 2021-04, Vol.61 (2), p.290-296
Main Authors: Ma, Jolande, Brown, Bevan, Liang, Eisen
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Brown, Bevan
Liang, Eisen
description Background Failing conservative therapies, uterine artery embolisation (UAE) has been proposed as a uterine‐sparing option for treatment of symptomatic adenomyosis. UAE appears effective at short‐term; however long‐term durability is less well established. Aims To evaluate the long‐term clinical efficacy of UAE for treatment of adenomyosis. Materials and Methods One hundred and four women with initial clinical success following UAE for adenomyosis (results previously published) were further followed with a two‐part online survey. Part one inquired about menopause, symptom recurrence, need for further intervention and overall satisfaction. Part two comprised the Uterine Fibroid Symptom and health‐related Quality of Life (UFS‐QOL) questionnaire. Maintenance of clinical success was defined as remaining ‘happy’ or ‘very happy’ with overall outcome, no recurrence of symptoms, or need for further intervention. Results Of those women with initial success, 91/104 (88%) participated in this long‐term study at mean 52 months following UAE. Maintenance of clinical success was demonstrated in 82/91 (90%) women. For the remaining 9/91 (10%) women, mean time to failure was 31 months. There were 53/91 (58%) women who reached menopause at mean age of 51.5 years, occurring at mean 30 months post‐UAE. UFS‐QOL demonstrated significant decrease in symptom severity from 58.9 to 20.0 (P 
doi_str_mv 10.1111/ajo.13304
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UAE appears effective at short‐term; however long‐term durability is less well established. Aims To evaluate the long‐term clinical efficacy of UAE for treatment of adenomyosis. Materials and Methods One hundred and four women with initial clinical success following UAE for adenomyosis (results previously published) were further followed with a two‐part online survey. Part one inquired about menopause, symptom recurrence, need for further intervention and overall satisfaction. Part two comprised the Uterine Fibroid Symptom and health‐related Quality of Life (UFS‐QOL) questionnaire. Maintenance of clinical success was defined as remaining ‘happy’ or ‘very happy’ with overall outcome, no recurrence of symptoms, or need for further intervention. Results Of those women with initial success, 91/104 (88%) participated in this long‐term study at mean 52 months following UAE. Maintenance of clinical success was demonstrated in 82/91 (90%) women. For the remaining 9/91 (10%) women, mean time to failure was 31 months. There were 53/91 (58%) women who reached menopause at mean age of 51.5 years, occurring at mean 30 months post‐UAE. UFS‐QOL demonstrated significant decrease in symptom severity from 58.9 to 20.0 (P &lt; 0.001); and significant increase in QOL from 40.3 to 86.3 (P &lt; 0.001). Conclusions Long‐term durability of UAE for treatment of adenomyosis was demonstrated, with cumulative success rate of 80% at mean 52 months. UAE did not appear to bring forward menopause. UAE should be considered as an alternative to hysterectomy to treat adenomyosis.</description><identifier>ISSN: 0004-8666</identifier><identifier>EISSN: 1479-828X</identifier><identifier>DOI: 10.1111/ajo.13304</identifier><identifier>PMID: 33583017</identifier><language>eng</language><publisher>Australia: John Wiley and Sons Inc</publisher><subject>Original</subject><ispartof>Australian &amp; New Zealand journal of obstetrics &amp; gynaecology, 2021-04, Vol.61 (2), p.290-296</ispartof><rights>2021 The Authors. published by John Wiley &amp; Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists.</rights><rights>2021 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology published by John Wiley &amp; Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4154-2a10cab042a89f9f33159f41834bfb4eee000aed78893d24a0ff385e5dc4c86e3</citedby><cites>FETCH-LOGICAL-c4154-2a10cab042a89f9f33159f41834bfb4eee000aed78893d24a0ff385e5dc4c86e3</cites><orcidid>0000-0002-5314-8274 ; 0000-0003-0306-4133</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33583017$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ma, Jolande</creatorcontrib><creatorcontrib>Brown, Bevan</creatorcontrib><creatorcontrib>Liang, Eisen</creatorcontrib><title>Long‐term durability of uterine artery embolisation for treatment of symptomatic adenomyosis</title><title>Australian &amp; New Zealand journal of obstetrics &amp; gynaecology</title><addtitle>Aust N Z J Obstet Gynaecol</addtitle><description>Background Failing conservative therapies, uterine artery embolisation (UAE) has been proposed as a uterine‐sparing option for treatment of symptomatic adenomyosis. UAE appears effective at short‐term; however long‐term durability is less well established. Aims To evaluate the long‐term clinical efficacy of UAE for treatment of adenomyosis. Materials and Methods One hundred and four women with initial clinical success following UAE for adenomyosis (results previously published) were further followed with a two‐part online survey. Part one inquired about menopause, symptom recurrence, need for further intervention and overall satisfaction. Part two comprised the Uterine Fibroid Symptom and health‐related Quality of Life (UFS‐QOL) questionnaire. Maintenance of clinical success was defined as remaining ‘happy’ or ‘very happy’ with overall outcome, no recurrence of symptoms, or need for further intervention. Results Of those women with initial success, 91/104 (88%) participated in this long‐term study at mean 52 months following UAE. Maintenance of clinical success was demonstrated in 82/91 (90%) women. For the remaining 9/91 (10%) women, mean time to failure was 31 months. There were 53/91 (58%) women who reached menopause at mean age of 51.5 years, occurring at mean 30 months post‐UAE. UFS‐QOL demonstrated significant decrease in symptom severity from 58.9 to 20.0 (P &lt; 0.001); and significant increase in QOL from 40.3 to 86.3 (P &lt; 0.001). Conclusions Long‐term durability of UAE for treatment of adenomyosis was demonstrated, with cumulative success rate of 80% at mean 52 months. UAE did not appear to bring forward menopause. 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UAE appears effective at short‐term; however long‐term durability is less well established. Aims To evaluate the long‐term clinical efficacy of UAE for treatment of adenomyosis. Materials and Methods One hundred and four women with initial clinical success following UAE for adenomyosis (results previously published) were further followed with a two‐part online survey. Part one inquired about menopause, symptom recurrence, need for further intervention and overall satisfaction. Part two comprised the Uterine Fibroid Symptom and health‐related Quality of Life (UFS‐QOL) questionnaire. Maintenance of clinical success was defined as remaining ‘happy’ or ‘very happy’ with overall outcome, no recurrence of symptoms, or need for further intervention. Results Of those women with initial success, 91/104 (88%) participated in this long‐term study at mean 52 months following UAE. Maintenance of clinical success was demonstrated in 82/91 (90%) women. For the remaining 9/91 (10%) women, mean time to failure was 31 months. There were 53/91 (58%) women who reached menopause at mean age of 51.5 years, occurring at mean 30 months post‐UAE. UFS‐QOL demonstrated significant decrease in symptom severity from 58.9 to 20.0 (P &lt; 0.001); and significant increase in QOL from 40.3 to 86.3 (P &lt; 0.001). Conclusions Long‐term durability of UAE for treatment of adenomyosis was demonstrated, with cumulative success rate of 80% at mean 52 months. UAE did not appear to bring forward menopause. UAE should be considered as an alternative to hysterectomy to treat adenomyosis.</abstract><cop>Australia</cop><pub>John Wiley and Sons Inc</pub><pmid>33583017</pmid><doi>10.1111/ajo.13304</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-5314-8274</orcidid><orcidid>https://orcid.org/0000-0003-0306-4133</orcidid><oa>free_for_read</oa></addata></record>
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title Long‐term durability of uterine artery embolisation for treatment of symptomatic adenomyosis
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