Topics of Interest

Outcomes after Uterine artery Embolization for Pedunculated Subserosal Leiomyomas

Journal: Journal of Vascular and Interventional Radiology. 2008;19:657-661.
Authors: Margau R, Simons M, Rajan D, Hayeems E, Sniderman K, Tan K, Beecroft R, Kachura J.
Study from: Department of Medical Imaging, New York Hospital and Mount Sinai Hospital, New York
Problem: In the early days of uterine artery embolization there were two published instances where pedunculated fibroids (on a stalk) detached from the uterus and caused inflammation in the abdomen which required surgery to remove the fibroid. However, we did not know whether this was a frequent or rare problem.

Study: Among 240 women who had UAE, 16 women had fibroids on a stalk on the outside of the uterus. The average size of the fibroid was about 7 cm (3 inches) in diameter. The average width of the stalk was 2.7 cm (1 inch) and 6 fibroids had a stalk less than 2 cm in width.

Results: None of the 16 women had a pedunculated fibroid detach as a result of UAE. The average reduction in size of the fibroid was 39%, the same results that have been published for other types of fibroids.

Dr. Parker’s Comments: These results are very encouraging and will allow more women to have UAE. The only problem with the study is that it is possible, in fact likely, that some women with large fibroids on long or thin stalks were not recommended for UAE in the first place. So, the recommendation for UAE will depend on the interpretation of the MRI by the interventional radiologist.  More about UAE can be found here: http://www.fibroidsecondopinion.com/uterine-artery-embolization/

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2 Comments

  1. naira
    Posted November 26, 2011 at 3:23 am | Permalink

    For many years I was told to have Fibroids. This year after a sonogram done in a different place I was told that that I have adenomyosis and there are no Fibroids. MRI result confirms Adenomyosis as well. I can’t understand how is that possible. I want to know if embolization will help me to reduce the pain and blood loss every month?

  2. Posted November 26, 2011 at 8:31 am | Permalink

    Adenomyosis can cause the uterus to enlarge, mimicking the feel of fibroids on pelvic exam. MRI is the most accurate way to diagnose adenomyosis, so this is likely what you have. More about adenomyosis can be found on this webpage: http://www.fibroidsecondopinion.com/adenomyosis/

    Uterine artery embolization can treat the symptoms of adenomyosis about 50% of the time. If the adenomyosis is limited to a small area in the uterine wall, it can be removed either laparoscopically or through an abdominal incision and the uterus can be reconstructed by suturing. Unfortunately, the only know “cure” for adenomyosis at the present time is hysterectomy. However, the symptoms from adenomyosis do go away after menopause, and if you are close to menopause watchful waiting is another option.

    Bill Parker, MD

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Fibroid Doctor William H. Parker

Dr. William H. Parker is a board-certified Fellow in the American College of Obstetricians and Gynecologists. Dr. Parker is an internationally recognized expert in fibroid surgery and research. Based in Los Angeles, California, he is considered one of the best fibroid surgeons for abdominal and laparoscopic myomectomy in the United States and abroad. He has been chosen for Best Doctors in America and Top Doctors every year beginning in the late 90's.

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