Topics of Interest

Complication Rates and Effectiveness of Uterine Artery Embolization

Title: Complication Rates and Effectiveness of Uterine Artery Embolization in the Treatment of Symptomatic Leiomyomas: A Systematic Review and Meta-Analysis

Journal: American Journal of Roentgenology, 2012; volume 199, pages 1153-1163.

Authors: Sundeep S. Toor, Arash Jaberi, D. Blair Macdonald, Mathew D. F. McInnes, Mark E. Schweitzer and Pasteur Rasuli.

Study from: Department of Medical Imaging, Ottawa Hospital, Ontario, Canada.

Problem: Many studies of uterine artery embolization include small numbers of women and conclusions are difficult to make. A “meta-analysis” combines the results of many studies and analyzes them together in order to improve the accuracy of the conclusions.

Study: The study determined the rates of complications, need for other treatment after UAE and the rate of success of uterine artery embolization (UAE) for the treatment of fibroids.

Results: Fifty-four published studies were analyzed including 8,159 patients. Women were followed anywhere from 3 months to 5 years after UAE in the various studies. There were no reported deaths in these studies. Major complications occurred in 3% of women, including serious infection in 2%. About 1% of women needed a hysterectomy to treat complications of UAE. Four percent of women had permanent loss of menstrual periods. Every year after UAE, 5% of women needed either a repeat UAE, a myomectomy or a hysterectomy due to failure of UAE to help symptoms. Most of the failures occurred in the first 2 years after UAE. About 3% of women needed to be readmitted to the hospital. Other complications included passing fibroid tissue through the vagina after UAE (5%). Fewer complications occurred in recent studies than in the early studies of UAE as techniques have improved. UAE was successful for 78% to 90% of women.

Authors’ Conclusions: UAE is an effective procedure for treatment of symptomatic uterine fibroids with a low rate of major complications, supporting its use as an alternative to hysterectomy.

Dr. Parker’s Comments: The results of this study of more than 8,000 women who had UAE are very reassuring. 80-90% of women are satisfied with UAE. Also, the risk of having a major complication from UAE is lower than for hysterectomy. However, the need for readmission to the hospital after UAE or the need for another fibroid treatment is greater than the rates for hysterectomy.

 

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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 San Diego, 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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