Presentation
Multiple years of menometrorrhagia with anaemia
Patient Data
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 embolisation was performed.
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 post-embolisation 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 embolisation (UFE) is a safe and effective to treat uterine fibroid especially for patients who wish for conservative treatment. A multicentre trial taken in Ontario on 538 patients showed a significant improvement at 3 months follow-up in 83% of metrorrhagia and 77% of dysmenorrhoea, respectively.
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