I-43: Uterine Artery Embolization(UAE),An Alternative Treatment for Fibroids

Background: To evaluate the results (rates of success, complications and clinical outcomes), advantages or disadvantages of Uterine Artery Embolization (UAE). Materials and Methods: We were able to follow 28 women with uterine fibroids, ranging age of 21 to 48 years (mean age 34 y), who underwent UAE in Mostafa Khomeini Hospital from May 2005 to June 2014, for the period of 6 months to 8 years. Twenty patients (71.5%) were nulliparous, 6(21.5%) were primiparous and 2(7%) had two previous pregnancies. UAE performed by femoral approach, local anesthesia and using the seldinger technique to achieve bilateral uterine artery embolization while using 355-700 PVA particles. Results: Bilateral UAE was successful in 27 patients and unilateral embolization performed in one case. Decrease in uterine volume was 32-58% and decrease in size of (dominant) fibroid volume was about 43 to 80%. Post-embolization syndrome was seen in about 40% of patients with different degrees while they were well managed as out-patients. Improvement in menorrhagia, pelvic pain and bulk effect were seen in 90-98%. No major complications or need for re-admission or progress to hysterectomy was observed. Conclusion: UAE is a valuable alternative treatment for symptomatic fibroids, especially in women who want to preserve their uterus (but when patients seek for certainty on the cessations of problems, hysterectomy remains the treatment of choice).