1Rafay Gul, 1Ammad Hussain , 1Ammad Hussainziz

1Dr. Ziauddin University Hospital

Introduction(s):

Uterine fibroid is the most common pelvic tumour in women that leads to gynaecological haemorrhage, lower abdominal pain, dysmenorrhea and infertility. Uterine artery embolization (UAE) is one of the minimally-invasive alternatives to hysterectomy for the treatment of uterine leiomyomas.  This study aimed to evaluate the effect of uterine artery embolization on treating and reducing the size of symptomatic uterine fibroids.

Material(s) and Method(s):

It is a retrospective study done on 67 patients who had undergone uterine artery embolization for symptomatic fibroids at the Interventional Radiology department of Ziauddin University Hospital Karachi during the period from 1st June 2016 to 1st June 2021, in collaboration with the department of gynaecology and obstetrics of our institute. Clinical demographics, presenting symptoms, uterine and fibroid characteristics on pre and post-procedural imaging were analyzed.

Result(s):

67 patients underwent uterine artery embolization with pre & post MRI assessment. In terms of location of the dominant fibroids, 35 patients (52%) had transmural tumors (FIGO II-IV), 23 patients (34%) had submucosal cum intra-mural tumor (FIGO 0-I), 9 patients (14%) had tumors in sub serosal cum intra-mural location (FIGO V-VI). We classified UAE treatment response as under <30%, 30-50% &> 50% volume reduction on 6 months post embolization MRI. 6 months follow-up MRI shows >50 % of fibroid volume reduction in 23(34%) patients, 30-50% of volume reduction in 34(51%) patients and < 30% in 4(6%) no of patients. 100% technical success was obtained with complete embolization of tortuous & dilated uterine arteries with resolution of symptoms. Clinical success was achieved in 61/67 (91%) of patients. Two patients showed increase in fibroid size & volume due to very enlarged size multi-fibroid uterus. Two patients in class C shows no response to treatment. Two patients lost to follow-up.

Conclusion(s):

67 patients underwent uterine artery embolization with pre & post MRI assessment. In terms of location of the dominant fibroids, 35 patients (52%) had transmural tumors (FIGO II-IV), 23 patients (34%) had submucosal cum intra-mural tumor (FIGO 0-I), 9 patients (14%) had tumors in sub serosal cum intra-mural location (FIGO V-VI). We classified UAE treatment response as under <30%, 30-50% &> 50% volume reduction on 6 months post embolization MRI. 6 months follow-up MRI shows >50 % of fibroid volume reduction in 23(34%) patients, 30-50% of volume reduction in 34(51%) patients and < 30% in 4(6%) no of patients. 100% technical success was obtained with complete embolization of tortuous & dilated uterine arteries with resolution of symptoms. Clinical success was achieved in 61/67 (91%) of patients. Two patients showed increase in fibroid size & volume due to very enlarged size multi-fibroid uterus. Two patients in class C shows no response to treatment. Two patients lost to follow-up.