Percutaneous treatment of uterine fibroleiomyomas: Analysis of complications and quality of life after embolization

Abstract

Purpose. To determine the rate complications and the quality of life of patients submitted to uterine artery embolization for the treatment of uterine fibroids. Material and method. Thirty-two women, aged 32-52yrs underwent bilateral embolization of the uterine artery. The patients were affected by menorrhagia (100%) associated with: anaemia in 9 cases, intense menstrual pain in 10 and pressure symptoms in 3. The embolization procedure consisted of selective catheterization of the uterine arteries and injection of embolic particles (PVA). A questionnaire was administered to 27 patients over a period of 4-16 months to evaluate the patients' quality of life after the treatment. Results. The procedure was technically successful in 30/32 patients. Twenty-nine of the embolized patients complained of heavy post-procedure pain associated with asthenia and malaise. Two patients were lost in the follow-up period. In seven patients (21.8%) different complications occur in the follow-up period. Two patients required hysterectomy: one for recurrent infections that required multiple admissions to hospital, and one as an emergency for the development of a large purulent collection in the uterus. Nineteen out of 27 completed the questionnaire. Conclusions. Our results indicate a high level of satisfaction with the treatment and a relatively low complication rate, which suggest that uterine embolization can be considered as a new promising option for uterine fibroids. However, before the treatment can be adopted in clinical practice, randomized trials are required to compare the treatment with the standard surgical procedures such as myomectomy and hysterectomy.