Uterine artery embolisation for fibroid disease: results of a 6 year study

Uterine myomata are very common. Failed treatment frequently leads to major surgery. Therefore, noninvasive techniques, such as uterine artery embolisation (UAE) are of great interest and were first reported by Ravina et al, to treat symptomatic myomata initially scheduled for surgery. The objectives of this 6 year study were to evaluate UAE as the only treatment of myomata. Between 1991 and 1997, 184 women with symptomatic myomata were prospectively enrolled in the study. Bilateral, particular UAE was performed with polyvinyl alcohol (PVA, Ivalon) under local anaesthesia and analgesia during a 24 h hospitalisation. Women's ages ranged from 21 to 54 years (mean 41). Menorrhagia was present in 93% of cases, pain in 22%, enlarged uterus in 25%. Myomata were interstitial (77%), subserous (16%) or submucous (7%). Multiple myomata were common (in 80%, greater than or equal to 3 myomata) mean myomata diameter 58 mm. 157 cases could be evaluated (19 were lost during follow-up and there were eight catheterisation failures). The mean duration of follow-up was 29 months. Success with menorrhagia and uterine volume reduction, without subsequent surgery, was observed in 90% of cases. Most of the incidents (10%) were benign and observed before 1996, including catheterisation failure and five definitive amenorrhea. In seven patients, eight pregnancies were observed. These data confirm our previous reports and other studies on the safety and efficacy of UAE as the only treatment of uterine myomata.