Uterine Artery Embolization for Leiomyoma / 대한산부인과학회잡지

ABSTRACT

OBJECTIVE: To evaluate the role of uterine artery embolization as treatment for symptomatic uterine leiomyoma. METHODS: From January 2000 to March 2002, 40 consecutive patients (mean age, 42.5 years; range, 27-53 years) underwent uterine artery embolization for the treatment of uterine leiomyomas. After a nonselective pelvic arteriogram was obtained, bilateral embolization was performed in each case. After discharge from the hospital, the patients were followed up at regular intervals (at 1st, 2nd, 3rd months, at 6th months, at 12 months and annually thereafter). The mean duration of follow-up was 11.5 months (range; 2-30 months). During the follow-up period, consecutive myoma volume, serum hemoglobin, menstrual index (MI) were checked. All patients were contacted by telephone to confirm any change in their symptoms after the embolization and were questioned regarding their satisfaction with the procedure. RESULTS: A total of 40 patients were treated successfully. Initially, the presenting symptoms of the participants were menorrhagia (34/40, 85%), dysmenorrhea (14/40, 35%) and bulk symptoms (4/40, 10%). Most patients had improvement in symptoms by 3 months after the procedure and patient satisfaction paralleled the symptom change. Of 34 patients who initially presented menorrhagia, 28 patients checked their own serum hemoglobin levels and recorded MI regularly. The patterns of change of serum hemoglobin levels and MI during follow-up period were statistically correlated with their symptom changes. And the mean dominant myoma volume was reduced by 40% after 1 month, by 56% after 3 months, by 71% after 6 months and by 72% after 12 months (ANOVA, SAS 8.0, p<.0007). CONCLUSION: We conclude that uterine artery embolization for leiomyoma is minimally invasive and effective method of treatment. Most patients report improved symptoms and satisfaction with the outcome from treatment.