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Uterine Artery Embolization for the Treatment of Uterine Fibroids
by Martin L Schwartz, MD, Ph.D., Arnold Klein, MD, and Bruce McLucas, MD
CONTEMPORARY OBGYN August 2001 Volume 46 No. 8 pp. 14-37
Summary
Embolization of uterine myomata is an alternative to surgical therapy for many women. The effects of the procedure appear to be permanent, with few long term complications other than premature menopause. Patients who have symptomatic, isolated pedunculated myomata may be candidates for endoscopic techniques in addition to embolization. Large uteri, greater than 20 centimeters in size may have a higher chance of post embolization sepsis, and a lower probability that the 50% shrinkage will be enough to control symptoms. Concern has also been raised that large submucosal myomas may have an increased risk of sepsis. Young women desiring fertility must be cautioned concerning the small, but real, risk of premature menopause, and the uncertainty surrounding the possibility of decreased ovarian reserve.
For the gynecologist, management of the postprocedure prolapsing submucous myoma, and the evaluation of the post embolization syndrome will present new challenges not encountered before in practice.
Even with these cautionary notes, a substantial percentage of women with symptomatic uterine myoma will benefit from this new development in therapy.
As an educational service, members of the FTC provide questions and answers regarding fibroids. Please note that the questions and answers are not medical advice and there is no substitute for diagnosis and, where appropriate, treatment by a qualified and licensed physician of your own choosing.