Effect of selective uterine artery embolization on symptomatic uterine fibroids

Objective: To evaluate the outcomes of selective uterine artery embolization (SUAE) in treatment of symptomatic uterine fibroids using Color Doppler ultrasonography (CDUS). Methods: As the procedure SUAE for fibroids, prospective data of the initial 65 consecutive women treated from March 2007 to September 2009 were collected. The follow-up period from 1 week to 30 months, using questionnaires, we investigated the fibroid-related physical and psychological symptoms, and the cumulative rates of symptom control, gynecologic interventions, and complications. The volumes of uterine and uterine fibroids were calculated by CDUS pre- and post-SUAE for 6 months. And we tested the levels of internal hormone including FSH, LH and E2 before and after SUAE for 3, 6 months. Results: SUAE was performed successfully in all patients. There was no peri-operative morbidity in all procedures. Compared with pre-SUAE volumes of uterine [(322±112) cm3] and uterine fibroids [(125±46) cm3], their volumes in post-SUAE were (144±72) cm3 and (51±11) cm3 (P<0.01), and reduction rate was 58% and 61%, respectively. At 3, 6 months after SUAE, levels of FSH, LH, and E2 were not decreased than that of in pre-SUAE (P>0.05). After SUAE for 24 months, the fibroids related physical and psychological symptoms such as bleeding, pain and quality of life were significantly improved (P<0.01). 90.8% (59/65) women had resolution of symptoms and no significant post-procedural symptoms. Parts of patients discharge necrotic fibroids. 86% (34/40) complications were minor, requiring no therapy. 9.2% (6/65) had significant post-procedural symptoms, requiring therapy in hospital or out-patient department. Conclusion: SUAE contributes to a long-term significant improvement of all investigated uterine fibroid-related symptoms and markedly improves women's health-related quality of life. SUAE that no impair on changes of internal hormone, under suitable conditions, represents an attractive alternative to hysterectomy for the treatment of symptomatic fibroids and is a minimally invasive, new method of good clinical prognosis. CDUS is an effective to investigate the outcome of SUAE.