Published online by Cambridge University Press: 10 November 2010
This chapter will examine the failures of uterine artery embolization (UAE) in our center. The overall results of UAE and our standard to define failures have been discussed in Chapter 14. In short, these standards are minimal or no shrinkage, no relief of symptoms, and hysterectomy. Here, we will also discuss technical failures and failures to achieve fertility.
In our practice, we perform endoscopic evaluations of the uterus, as well as taking into account the possible contraindication or factors that may lead to failure. We exclude patients prior to embolization using the scheme outlined in the Chapter 14. Prevention of failure starts with selecting the correct procedure. We have excluded six patients with gynecologic malignancy. Twelve patients who presented with acute uterine hemorrhage and were embolized prior to endoscopic evaluation on an emergency basis were evaluated with endoscopy after embolization. One of these patients was discovered to have a malignancy and was referred for a definitive therapy. We also excluded 22 patients with atypical endometrial hyperplasia and eight patients with acute pelvic infection.
Definition of failure
Shrinkage alone is not a sole criterion of success. Later in this chapter, we will analyze patients who presented with uterine shrinkage of 50%, but they could not be categorized into the success group.