Uterine Artery Embolization for the Treatment of Symptomatic Fibroids

PURPOSE: The aim of this study was to determine the potential usefulness of uterine artery embolization (UAE) for the management of uterine leiomyoma. MATERIALS AND METHODS: Sixty nine patients (mean age; 40.3 years, age range; 31-52 years) who underwent UAE for symptomatic fibroids (with menorrhagia, dysmenorrhea and bulk-related symptoms) from January 2000 to December 2000 were retrospectively analyzed. The mean follow-up period was 3.5 months (range: 1-8 months). The fibroids ranged in size from 2.0 cm to 13.2 cm with a mean size of 5.8 cm. We performed embolization using polyvinyl alcohol particles (250-710microgram). The improvement of the clinical symptoms was analyzed. Reduction of the uterine and predominant fibroid volumes was assessed using MRI. RESULTS: Symptom improvement for the menorrhagia (87.5%), dysmenorrhea (83.3%) and the bulk-related symptoms (79.2%) was reported. Complications included ovarian failure in four patients (5.8% of the total patients, mean age: 43.3 yrs) and infection in three patients (4.3% of the total patients) who underwent conservative management with intravenous antibiotics and analgesics. The volume reduction rate of the uterus and the predominant fibroids after uterine artery embolization were 36.3% and 56.6%, respectively. CONCLUSION: UAE is a promising new treatment for symptomatic fibroids and may be a valuable alternative to hysterectomy.

Transvaginal Expulsion of Intramural Leiomyoma after Uterine Artery Embolization: Case Report

We report a case in which an intramural uterine leiomyoma was transvaginally expelled after uterine arterial embolization (UAE). A 29-year-old unmarried female presented with vaginal bleeding, and at pre-treatment MRI an intramural leiomyoma was diagnosed. UAE was performed and after 13 days the tumor was transvaginally expelled. Follow-up MRI performed seven days later depicted a large myometrial defect in the anterior uterine wall; subsequent follow-up MRI showed that the defect became gradually smaller, and the size and configuration of the uterus progressively normalized.

CT Differentiation of Solid Ovarian Tumor and Uterine Subserosal Leiomyoma

PURPOSE: On the basis of CT findings, to differentiate between solid ovarian tumor and uterine subserosalmyoma. MATERIALS AND METHODS: In eight surgically proven cases of solid ovarian tumor and in ten uterinesubserosal myoma patients, contrast-enhanced CT images were obtained. Two genitourinary radiologists reviewed thefindings with regard to degree of enhancement of the mass as compared with enhancement of uterine myometrium,thickening of round ligaments, visualization of normal ovaries, contour of the mass, and the presence of ascitesin the pelvic cavity. RESULTS: Six of eight ovarian tumors but only two of ten uterine myomas were less enhancedthan normal uterine myometrium (p 0.05). The contour of themass was lobulated in two of eight ovarian tumor patients, but in five of ten uterine myoma patients (p>0.05). CONCLUSION: CT findings suggestive of solid ovarian tumor were less contrast enhancement of the mass than ofnormal uterine myometrium, pelvic ascites, and nonvisualization of normal ovary.