Fertility and sterility · 2006
Failure of uterine fibroid embolization.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Huang Jack Y J, Kafy Souzan, Dugas Alexandre, Valenti David, Tulandi Togas
Аннотация
OBJECTIVE: To assess the outcomes of patients who underwent uterine fibroid embolization (UFE) and to evaluate factors associated with failure of UFE.
DESIGN: Retrospective study.
SETTING: University teaching hospital.
PATIENT(S): Two hundred thirty-three consecutive patients who underwent UFE from November 1997 to February 2004.
INTERVENTION(S): Uterine fibroid embolizations were performed by three interventional radiologists using 355-500-mu polyvinyl alcohol particles.
MAIN OUTCOME MEASURE(S): Hysterectomy rate, myomectomy rate, and repeat UFE rate.
RESULT(S): With a mean follow-up of 13 months, a total of 22 patients underwent surgery after UFE (9.4%); 16 had hysterectomies (6.9%), and 6 had myomectomies (2.6%). This included 3 patients who underwent repeat UFE and subsequently required surgical intervention. The mean (+/- SEM) time interval between UFE and subsequent treatment was 12.5 +/- 2.0 months. Among patients who required surgery, 13 (59.1%) presented with recurrent menorrhagia, and 5 (22.7%) complained of persistent abdominal pain. Histopathologic examination revealed concomitant findings of adenomyosis in 25% of hysterectomy specimens. Patients who failed UFE were more likely to have had a previous myomectomy (13% vs. 2.4%) and significant reduction in the uterine size 6 months after UFE (57.1% vs. 25.2%).
CONCLUSION(S): The overall failure rate of UFE is 9.4%. Failure is mainly due to persistent menorrhagia and abdominal pain. Shrinkage of the uterus after UFE does not necessarily correlate with long-term success of UFE.
DESIGN: Retrospective study.
SETTING: University teaching hospital.
PATIENT(S): Two hundred thirty-three consecutive patients who underwent UFE from November 1997 to February 2004.
INTERVENTION(S): Uterine fibroid embolizations were performed by three interventional radiologists using 355-500-mu polyvinyl alcohol particles.
MAIN OUTCOME MEASURE(S): Hysterectomy rate, myomectomy rate, and repeat UFE rate.
RESULT(S): With a mean follow-up of 13 months, a total of 22 patients underwent surgery after UFE (9.4%); 16 had hysterectomies (6.9%), and 6 had myomectomies (2.6%). This included 3 patients who underwent repeat UFE and subsequently required surgical intervention. The mean (+/- SEM) time interval between UFE and subsequent treatment was 12.5 +/- 2.0 months. Among patients who required surgery, 13 (59.1%) presented with recurrent menorrhagia, and 5 (22.7%) complained of persistent abdominal pain. Histopathologic examination revealed concomitant findings of adenomyosis in 25% of hysterectomy specimens. Patients who failed UFE were more likely to have had a previous myomectomy (13% vs. 2.4%) and significant reduction in the uterine size 6 months after UFE (57.1% vs. 25.2%).
CONCLUSION(S): The overall failure rate of UFE is 9.4%. Failure is mainly due to persistent menorrhagia and abdominal pain. Shrinkage of the uterus after UFE does not necessarily correlate with long-term success of UFE.