Uterine Artery Embolization: A Treatment Option for Symptomatic Fibroids in Postmenopausal Women

The authors tested the hypothesis that UAE is an effective treatment option in postmenopausal women with fibroid-related bulk symptoms. The authors retrospectively reviewed a prospectively acquired HI-IQ database. Between 2001 and 2004, 24 women with an average age of 52 years meeting the Stages of Reproductive Aging Workshop criteria for menopause underwent UAE for fibroid-related bulk symptoms. All patients underwent preprocedural gadolinium-enhanced magnetic resonance (MR) imaging to confirm the presence of fibroid disease and exclude other pathology. These patients were followed at 1-, 3-, 6-, 12-, and 24-month intervals to assess their clinical response to therapy. Clinical success was defined as a qualitative reduction in bulk symptoms. Postprocedural gadolinium-enhanced MR imaging was performed routinely between 3 and 6 months and at 12 or 24 months, if indicated. Technical success was achieved in 24 of 24 (100%) patients. The follow-up period ranged from 1 to 24 months with an average of 9 months. Clinical success was achieved in 22 of 24 (92%) women. There were no major complications in any of the patients. Mean uterine volume was reduced by 564 cc (P < .0001). Mean dominant uterine fibroid volume was reduced by 180 cm³ (P = .0015). Uterine artery embolization is a viable treatment option in carefully selected postmenopausal women with fibroid-related bulk symptoms.

Abbreviations: CI, confidence interval, FOV, field of view, HASTE, half-Fourier acquisition single-shot turbo-spin echo T2, SHARP, SHARed pre-pulse fat saturation technique, STRAW, Stages of Reproductive Aging Workshop, T1 FS GRE, T1-weighted fat-suppressed gradient echo, T2-TSE, T2-weighted turbo spin-echo, UAE, uterine artery embolization