Selective uterine artery embolization as primary treatment for symptomatic leiomyomata uteri

Study Objective. To analyze initial experience with uterine artery embolization for treatment of symptomatic leiomyomata. Design. Prospective, longitudinal study (Canadian Task Force classification II-2). Setting. Private practice, university-affiliated hospital. Patients. Three hundred five women (age 26-52 yrs). Interventions. Uterine artery embolization, performed over 2 years by a single radiologist working in collaboration with a single gynecology practice. Measurements and Main Results. Embolization was technically successful in 96% of patients. No major complications occurred. Average reduction in uterine volume was 48%. Control of menorrhagia was reported by 86% of patients at 3 months, 85% at 6 months, and 92% at 12 months after the procedure. Bulk symptoms were satisfactorily controlled in 64% of patients at 3 months, 77% at 6 months, and 92% at 12 months. Six women subsequently underwent hysterectomy and five had myomectomy. Conclusion. Uterine artery embolization appears to be a highly effective treatment for symptomatic uterine leiomyomata. Its impact on fertility and pregnancy remain to be investigated fully.