Role of Uterine Artery Embolization using Embolic Microspheres in Treatment of Uterine Fibroid

Abstract Background Uterine Artery Embolization (UAE) is a well-established treatment of symptomatic fibroids with clinical efficacy comparable with traditional surgical treatment. UAE is now commonly proposed as an organ preserving treatment to the population of younger women willing to conceive. It has been proven, in a large cohort of women wishing to conceive before embolization, that complete pregnancies can occur after UAE Objectives The study aims to assess the effect of uterine artery embolization using the different types of embolic microspheres in treatment of patients with uterine fibroid. Patients and Methods Type of Study: prospective study. Study Setting: At the radiology department of Ain Shams University hospitals and Ain Shams University Specialized Hospitals. Study Period: 6-12 months. Results High symptom severity score indicates severe symptoms and a high HRQOL score indicates a good quality of life. The mean UFS questionnaire baseline score was 70± 11.51 prior to embolization and became 45± 9.34 three months following embolization which indicates a good symptomatic response to the microspheres embolization. The mean QOL baseline score was 65± 8.58 prior to embolization and 81± 6.48 three months following embolization. Conclusion UAE using embolic microsphere is , an effective, minimally invasive procedure and easily one day procedure which showed competitive promising and well proved results when compared to other modalities outcomes in treating uterine fibroids such as conventional surgery. It deserves our attention to it's value and efficacy for the sake of the patient as a minimally invasive procedure providing better quality of life , using Embosphere and Embozene microspheres have the same symptomatic effect and volume reduction after three months follow up in compare with using Embosphere alone or with spherical polyvinyl alcohol particles.

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ASSESSMENT OF THE UFS-QOL QUESTIONNAIRE BEFORE AND AFTER UTERINE ARTERY EMBOLIZATION FOR UTERINE LEIOMYOMA

10.25005/2074-0581-2020-22-3-362-372 ◽

2020 ◽

pp. 362-372

Author(s):

A.K. BARATOV ◽

◽

F.R. RAKHIMOV ◽

E.L. KALMYKOV ◽

◽

...

Keyword(s):

Quality Of Life ◽

Uterine Artery Embolization ◽

Uterine Leiomyoma ◽

Uterine Artery ◽

Uterine Fibroids ◽

Artery Embolization ◽

Before And After ◽

Related Quality ◽

The Mean

Objective: To assess of the quality of life before and after uterine artery embolization (UAE) for uterine leiomyoma. Methods: A survey of 15 women aged 23 to 47 years was conducted using the UFS-QOL questionnaire. The number of fibroids varied from 1 to 6. Fibroids were mainly localized: submucosal (53.3%), intramural (20%), and subserosal (26.7%). Their volume varied in the range of 25.04-294.09 ml. The dominant syndrome in 7 cases was hemorrhagic, in 7 – compression, and in 1 case – their combination. All women underwent UAE. The survey was conducted four times: before, 3, 6 and 12 months after UAE. Results: According to symptom severity subscale of the UFS-QOL questionnaire (8 questions), there was a significant improvement in symptoms 12 months after UAE in comparison with the baseline: a decrease of mean score from 43.3 to 14.0 (p<0.001). Analysis of the health related quality of life (HRQL) subscale (29 questions) also showed a significant improvement in the quality of life after 12 months compared to the initial level: an increase of mean score from 54.3 to 82.8 (p<0.001). The most significant dynamics (p<0.001) was noted for such domains «Concern», «Activities», «Energy/mood», and «Control» (p<0.001). The mean scores for the above domains increased from the baseline values 53.3±16.0; 56.4±18.4; 42.9±18.0 and 53.7±20.1 to 86.0±11.2; 86.9±11.6; 75.2±10.0 and 81.3±11.2 points after 12 months, respectively. For 2 other subsections of the HRQL «Self-consciousness» and «Sexual function», the mean score changes slightly differed: 67.2±32.2 and 71.7±32.9 (initially) and 85.0±12.3 and 86.7±22.4 (after 12 months) (p<0.05 and p<0.01, respectively). The total HRQL mean score also significantly (p<0.001) increased by month 12 from the baseline of 54.3±14.7 to 82.8±7.4. Conclusions: The UFS-QOL questionnaire is a very informative tool for assessing both the severity of the symptoms of uterine fibroids and the quality of life of women who underwent uterine artery embolization. According to the results of the UFS-QOL, a significant dynamics was obtained with respect to both the regression of symptoms of uterine fibroids, and the improvement of all parameters of the quality of life. Keywords: Uterine leiomyoma, uterine artery embolization, quality of life, UFS-QOL questionnaire.

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Myoma of the uterus: the organ-preservation treatment (a review)

Aspirantskiy Vestnik Povolzhiya ◽

10.17816/2072-2354.2020.20.1.13-18 ◽

2020 ◽

Vol 20 (1-2) ◽

pp. 13-18

Author(s):

Elmira T. Nurmukhametova

Keyword(s):

Quality Of Life ◽

Organ Preservation ◽

Uterine Artery Embolization ◽

Uterine Artery ◽

Web Of Science ◽

Uterine Fibroids ◽

Artery Embolization ◽

Radical Method ◽

Methods Of Treatment

Uterine fibroids are one of the main causes of hysterectomy. This radical method of treatment allows to control such symptoms as pain and bleeding, but significantly worsens womens quality of life, preventing them from their childbearing function. This article includes the results of domestic and foreign studies on organ-preserving methods of treatment of uterine fibroids published within 10 years. The method of uterine artery embolization, which is preferred by an increasing number of doctors and patients suffering from fibroids, is also described in the article. The search for articles was carried out in the databases Pubmed, Web of Science, Scopus.

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Management of single submucosal fibroid in unmarried females with uterine artery embolization

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20200375 ◽

2020 ◽

Vol 9 (2) ◽

pp. 774

Author(s):

Sunil Kumar Juneja ◽

Gagandeep Kaur ◽

Muskan Chaudhary

Keyword(s):

Minimally Invasive ◽

Uterine Artery Embolization ◽

Uterine Artery ◽

Symptomatic Relief ◽

Invasive Procedure ◽

Benign Neoplasm ◽

Menstrual Bleeding ◽

Invasive Technique ◽

Artery Embolization ◽

Gnrh Analogues

Background: Uterine fibroids (leiomyomas) are the most common benign neoplasm of the female pelvis. The location of fibroids, whether submucosal, subserosal, pedunculated subserosal, intramural, or endocavitary, is important because signs and symptoms may be determined by location. Uterine artery embolization (UAE) for many patients is an effective alternative treatment to surgical therapy for fibroid tumors. It is a minimally invasive procedure, which allows for rapid recovery and return to normal activities. Objective of this study was to know the efficacy of minimally invasive technique UAE for reducing symptoms in sub-mucous uterine leiomyoma in unmarried females.Methods: This retrospective analysis was performed on 9 unmarried females with symptomatic single submucosal fibroid diagnosed on MRI with size range of 3.5 cms to 6.5 cms. They presented at Dayanand Medical College and Hospital, Ludhiana, Punjab in a period of 3 years from January 2016-December 2019. Inclusion criteria were unmarried females, single submucosal fibroid diagnosed on USG/MRI. Exclusion criteria was active infection, more than one fibroid in uterus, prior GnRH analogues treatment during the previous 3 months.Results: All patients presented with heavy menstrual bleeding (HMB) and dysmenorrhea, lower abdomen pain was encountered in 3 patients and 2 patients had inter-menstrual bleeding. Recurrent, UTI was there in 1 patient and 1 patient had vaginal discharge. All fibroids belonged to stage 1 FIGO classification. UAE was done and patients were followed for 6 months. Symptomatic success was seen in 100% patients and 77.77% patients expelled the fibroid per vaginally.Conclusions: UAE is alternative method of treatment for submucosal fibroids in unmarried females who do not want to undergo surgery. Proper case selection can give us good results and symptomatic relief.

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