CIO 2022-15 Uterine Artery Embolization: An Interventional Aid

Purpose: Fibroids are the commonest benign lesions of the uterus. They present with bleeding per vagina in majority of the cases. Surgical treatment consists of hysterectomy or myomectomy with or without salpingo-oophorectomy, with its inherent morbidity, prolonged hospital stay, and psychosocial problems. Surgery is not the best option, especially in nullipara women.

Materials and Methods: A total of 665 patients were treated with uterine artery embolization (UAE). The mean age was 33.71 ± 6.27 years. Thirty-eight patients had advanced carcinoma of the cervix, 608 patients had fibroids the of uterus, 19 patients had endometriosis. 57 patients were unmarried, 55 patients did not have any issue, 52 patients had associated hemodynamically significant cardiac disorders, 19 had polycystic renal disease, and 18 patients had hypernephroma. Seventy-six patients had multiple fibroids. UAE was done through contralateral femoral artery puncture bilaterally with the help of a Roberts Uterine Catheter. Ultrasonography was repeated after 2 months.

Results: UAE was successful in all patients. The mean procedural time was 66 minutes. The hospital stay was 1 day only. Bleeding stopped in all 665 patients. Twenty patients had recurrence of bleeding after 2 months and underwent surgery. Fibroids disappeared in 152 patients, decreased in size by more than 72% in 209 patients, and decreased in size by 50% to 75% in 114 patients. Ninety-five patients did not report back for ultrasonography. Thirty-eight patients had normal deliveries after UAE.

Conclusions: UAE is effective therapy to stop uterine bleeding. It is effective in controlling the symptoms in uterine fibroids and decreasing the size of fibroids. The hospital stay is only 1 day.