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Chapter 18 - Embolization for the Management of Uterine Fibroids

Published online by Cambridge University Press:  10 October 2020

Mostafa Metwally
Affiliation:
University of Sheffield
Tin-Chiu Li
Affiliation:
The Chinese University of Hong Kong
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Summary

Uterine fibroids are the most common benign tumour in premenopausal women, with a lifetime prevalence of almost 70% in Caucasian women and more than 80% in women of Afro-Caribbean descent. About half of these women experience symptoms, with the most common being menorrhagia, dysmenorrhoea, pressure symptoms and infertility. Whilst hysterectomy is still the most commonly offered and performed operation to treat uterine fibroids, over the last 20 years minimally invasive therapies have been gaining popularity and uterine fibroid embolization is now a mainstream option for most women who wish to preserve their uterus. Since its introduction, a strong body of evidence has built demonstrating safety and efficacy with low rates of complication. Uterine fibroid embolization (UFE) was first described as a treatment for symptomatic leiomyomas in 1995 by Ravina et al. and has proved so popular that in the last year there were over 25,000 uterine fibroid embolization procedures performed worldwide [1].

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Publisher: Cambridge University Press
Print publication year: 2020

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References

Ravina, JH, Herbreteau, D, Ciraru-Vigneron, N, et al. Arterial embolization to treat uterine myomata. Lancet 1995;346:671–2.Google Scholar
Chen, HT, Athreya, S. Systematic review of uterine artery embolization practice guidelines: are all the guidelines on the same page? Clin Radiol 2018;73:507.e9–15.Google Scholar
Razavi, MK, Wolanske, KA, Hwang, GL, et al. Angiographic classification of ovarian artery-to-uterine artery anastomoses: initial observations in uterine fibroid embolization. Radiology 2002;224:707–12.CrossRefGoogle ScholarPubMed
Smeets, AJ, Nijenhuis, RJ, Boekkooi, PF, et al. Safety and effectiveness of uterine artery embolization in patients with pedunculated fibroids. J Vasc Interv Radiol 2009;20:1172–5.Google Scholar
Rajan, DK, Margau, R, Kroll, RR, et al. Clinical utility of ultrasound versus magnetic resonance imaging for deciding to proceed with uterine artery embolization for presumed symptomatic fibroids. Clin Radiol 2011;66:5762.CrossRefGoogle ScholarPubMed
Kim, MD, Kim, YM, Kim, HC, et al. Uterine artery embolization for symptomatic adenomyosis: a new technical development of the 1-2-3 protocol and predictive factors of MR imaging affecting outcomes. J Vasc Interv Radiol 2011;22:497502.CrossRefGoogle ScholarPubMed
Binkert, CA, Hirzel, FC, Gutzeit, A, Zollikofer, CL, Hess, T. Superior hypogastric nerve block to reduce pain after uterine artery embolization: advanced technique and comparison to epidural anesthesia. Cardiovasc Intervent Radiol 2015;38:1157–61.Google Scholar
Yoon, J, Valenti, D, Muchantef, K, et al. Superior hypogastric nerve block as post–uterine artery embolization analgesia: a randomized and double-blind clinical trial. Radiology 2018. https://doc.org/10.1148/radiol.2018172714CrossRefGoogle Scholar
Resnick, NJ, Kim, E, Patel, RS, et al. Uterine artery embolization using a transradial approach: initial experience and technique. J Vasc Interv Radiol; 2014;25:443–7.CrossRefGoogle ScholarPubMed
Posham, R, Biederman, DM, Patel, RS, et al. Transradial approach for noncoronary interventions: a single-center review of safety and feasibility in the first 1,500 cases. J Vasc Interv Radiol 2016;27:159–66.Google Scholar
Hu, NN, Kaw, D, McCullough, MF, Nsouli-Maktabi, H, Spies, JB. Menopause and menopausal symptoms after ovarian artery embolization: a comparison with uterine artery embolization controls. J Vasc Interv Radiol 2011;22:710–1.Google Scholar
Noel-Lamy, M, Tan, KT, Simons, ME, et al. Intraarterial lidocaine for pain control in uterine artery embolization: a prospective, randomized study. J Vasc Interv Radiol 2017;28:1622.Google Scholar
Pelage, J-P, Guaou, NG, Jha, RC, Ascher, SM, Spies, JB. Uterine fibroid tumors: long-term MR imaging outcome after embolization. Radiology 2004;230:803–9.Google Scholar
National Institute for Health and Care Excellence. Uterine artery embolization (Interventional procedures guidance [IPG367]). 2010. Available at www.nice.org.uk/guidance/IPG367. Accessed 22 May 2018.Google Scholar
Royal College of Obstetricians and Gynaecologists. Uterine artery embolization in the management of fibroids. 2013. Available at: www.rcog.org.uk/en/guidelines-research-services/guidelines/uterine-artery-embolization-in-the-management-of-fibroids. Accessed 22 May 2018.Google Scholar
Gupta, JK, Sinha, A, Lumsden, MA, Hickey, M. Uterine artery embolization for symptomatic uterine fibroids. Cochrane Database Syst Rev 2014;(12):CD005073.Google Scholar
van Overhagen, H, Reekers, JA. Uterine artery embolization for symptomatic leiomyomata. Cardiovasc Intervent Radiol 2015;38:536–42.CrossRefGoogle ScholarPubMed
Myers, ER, Goodwin, S, Landow, W, et al. Prospective data collection of a new procedure by a specialty society: the FIBROID registry. Obstet Gynecol 2005;106:4451.Google Scholar
de Bruijn, AM, Ankum, WM, Reekers, JA, et al. Uterine artery embolization vs hysterectomy in the treatment of symptomatic uterine fibroids: 10-year outcomes from the randomized EMMY trial. Am J Obstet Gynecol 2016;215:745.e1–12.CrossRefGoogle ScholarPubMed
Moss, JG, Cooper, KG, Khaund, A, et al. Randomised comparison of uterine artery embolization (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST trial): 5-year results. BJOG 2011;118:936–44.Google Scholar
Dutton, S, Hirst, A, McPherson, K, Nicholson, T, Maresh, M. A UK multicentre retrospective cohort study comparing hysterectomy and uterine artery embolization for the treatment of symptomatic uterine fibroids (HOPEFUL study): main results on medium-term safety and efficacy. BJOG 2007;114:1340–51.CrossRefGoogle ScholarPubMed
McPherson, K, Manyonda, I, Lumsden, M-A, et al. A randomised trial of treating fibroids with either embolization or myomectomy to measure the effect on quality of life among women wishing to avoid hysterectomy (the FEMME study): study protocol for a randomised controlled trial. Trials 2014;15:100–11.Google Scholar
Carpenter, TT, Walker, WJ. Pregnancy following uterine artery embolization for symptomatic fibroids: a series of 26 completed pregnancies. BJOG 2005;112:321–5.Google Scholar
Goldberg, J, Pereira, L, Berghella, V, et al. Pregnancy outcomes after treatment for fibromyomata: uterine artery embolization versus laparoscopic myomectomy. Am J Obstet Gynecol 2004;191:1821.Google Scholar
Homer, H, Saridogan, E. Uterine artery embolization for fibroids is associated with an increased risk of miscarriage. Fertil Steril 2010;94:324–30.Google Scholar
Pisco, JM, Duarte, M, Bilhim, T, Cirurgiao, F, Oliveira, AG. Pregnancy after uterine fibroid embolization. Fertil Steril 2011;95:1121.e8.Google Scholar
Mohan, PP, Hamblin, MH, Vogelzang, RL. Uterine artery embolization and its effect on fertility. J Vasc Interv Radiol 2013;24:925–30.Google Scholar
Pron, G, Bennett, J, Common, A, et al. The Ontario Uterine Fibroid Embolization Trial. Part 2. Uterine fibroid reduction and symptom relief after uterine artery embolization for fibroids. Fertil Steril 2003 Jan;79(1):120–7.Google Scholar
Kitson, SJ, Macphail, S, Bulmer, J. Is pregnancy safe after uterine artery embolization? BJOG 2012;119:519–21.Google Scholar

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