OUTCOME OF UTERINE ARTERY EMBOLIZATION – A 12 MONTH FOLLOW UP OF CLINICAL OUTCOME AND FIBROID VOLUME REDUCTION

Abstract

Background :Uterine fibroid or leiomyomas are the most common benign uterine tumors and may be seen in upto 40 % of women in reproductive age. Though benign, fibroids are usually symptomatic and the associated menorrhagia hampers routine activities. Uterine artery embolisation [UAE] is an accepted alternative to surgical and medical treatment for symptomatic fibroids Objective : To analyze the efficacy of uterine artery embolization with reference to fibroid volume reduction as assessed by ultrasound. Methods: 32 patients between 21 to 45 years of age underwent UAE between 2010 and 2016. Following biochemical evaluation, preprocedure ultrasound with fibroid volume estimation was done using a Siemens Antares machine. Embolization of bilateral uterine arteries was carried out using gelfoam and Polyvinylalcohol spheres[330-500 ].Post procedure ultrasound was done at 1,3,6 and 12 months . Results:Of the 32 patients ,pre procedure ultrasound revealed fibroids in 26,molar pregnancy in 2,retained products in 2, adenomyosis and arteriovenous malformation in one each. Co morbidities included cardiac problems, uncontrolled diabetes, severe anemia and thyroid cancer. Post procedure 2 patients underwent hysterectomy, 2 developed amenorrhea,rest regained regular menstrual flow. 3. Of the 26 patients with fibroids pre procedure mean fibroid volume was 253cm Mean reduction in Fibroid volume was 34%,66%,79% and 81% at 1,3,6 and 12 months.The mean reduction in fibroid volume was statistically significant. Conclusion: UAE is an effective method in treatment of Fibroids and Ultrasound with volume estimation is adequate for follow up.