Uterine fibroid embolization

Case contributed by Dr Sovann Vathana Lay

Presentation

Multiple years of menometrorrhagia with anemia

Patient Data

Age: 45 years
Gender: Female

MRI

MRI

Multiple large enhancing uterine fibroids (max 4.2 cm). Neither of them presented with atypical or hyalin degeneration appearance.

The patient was given a recommendation for radical hysterectomy from the surgeon. However, she decided on uterine preservation so endovascular embolization was performed.

DSA (angiography)

A selective left internal iliac artery angiogram found an arterial blush which corresponded to the fibroids and no utero-ovarian anastomosis. 2 ml of 700µm microparticles was administered after superselective run of left uterine artery.

A right uterine artery run was performed successively which showed a large arterial blush linked to the fibroids. 1.5 ml of 700µm microparticles was administered.

Control runs demonstrated satisfactory flow reduction.

3 Months MRI Followup

MRI

3 months post-embolization MRI was performed and showed a satisfactory devascularisation of all fibroids. Both fibroids and uterus exhibited expected size reduction. The patient's symptom got better.

Case Discussion

Uterine fibroid embolization (UFE) is a safe and effective to treat uterine fibroid especially for patients who wish for conservative treatment. A multicenter trial taken in Ontario on 538 patients showed a significant improvement at 3 months follow-up in 83% of metrorrhagia and 77% of dysmenorrhea, respectively.

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