The effectiveness of combined abdominal myomectomy and uterine artery embolization.

OBJECTIVE

To evaluate the efficacy of abdominal myomectomy after uterine artery embolization (UAE-AM) among patients with myomas.

METHODS

In a retrospective study, chart data were reviewed for patients attending a center in California, USA, who underwent UAE-AM between 1999 and 2012. Patients had been offered the combined procedure if the diameter of the myoma was at least 4cm, they wished to preserve fertility, or they were candidates for a traditional abdominal myomectomy. Estimated blood loss, fluoroscopy times, and hospital stay were recorded. Follow-up data on uterine volume and fibroid size had been collected via magnetic resonance imaging or ultrasonography approximately 3-6 months after UAE-AM.

RESULT: Overall, 20 patients underwent UAE-AM. Approximately 6 months after the procedure, the mean decrease in uterine volume was 77.33%±14.25% and that in myoma diameter was 46.45%±25.61%. Six women subsequently became pregnant; one patient had two separate pregnancies. No patient required a conversion to hysterectomy or blood transfusion, and no recurrences were reported.

CONCLUSION

UAE-AM was found to be an effective option available to women with large myomas who wished to preserve their uterus. With the combination procedure, patients had favorable outcomes with no fibroid recurrence.