Mid-term Results and Efficacy of Uterine Artery Embolisation for Symptomatic Fibroids in the Local Population
KYK Wong, VWT Chan, PCH Kwok, KY Leung
Hong Kong J Radiol 2016;19:239-48
DOI: 10.12809/hkjr1615307
Objective: To assess the efficacy and safety of uterine artery embolisation (UAE) for treatment of symptomatic fibroids in Hong Kong Chinese women.
Methods: A retrospective analysis of consecutive patients who underwent UAE between June 2005 and December 2013 in a regional hospital in Hong Kong was performed. All patients had a magnetic resonance imaging (MRI) before and after UAE. Uterine and fibroid volumes were calculated from MRI scans to assess radiological improvement. Symptoms including abnormal uterine bleeding, dysmenorrhoea, urinary frequency, and abdominal distension were recorded.
Results: A total of 61 patients were assessed. The technical success rate was 98% with only one failure. Therapeutic hysterectomy or myomectomy was performed in 13%. The mean uterine volume decreased from 897.5 ml to 608.4 ml (32.2% reduction). The mean volume of the largest fibroid decreased from 258.7 ml to 169.9 ml (34.3% reduction). Symptomatic improvement was achieved for abnormal uterine bleeding (85%), dysmenorrhoea (86%), and urinary frequency (82%). There was an improvement in mean haemoglobin level from 100 g/l to 119 g/l and also a decreased number of patients using transamin following UAE from 72% (44/61) to 44% (22/50). Minor complications including fever, urinary tract infection, vaginal discharge, and post-embolisation syndrome occurred in a minority of patients. Three women developed permanent amenorrhoea after UAE. Fibroid expulsion occurred in three patients within 3 months of UAE without the need for hospitalisation.
Conclusion: Local data support the application of UAE as a safe and effective treatment for women with symptomatic fibroids. A high clinical success rate and fibroid volume reduction can be achieved.
Authors’ affiliations:
KYK Wong, VWT Chan, PCH Kwok: Department of Radiology and Imaging, Queen Elizabeth Hospital, Jordan, Hong Kong
KY Leung: Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Jordan, Hong Kong
中文摘要
子宮動脈栓塞術對症狀性纖維子宮肌瘤的本地患者的中期結果和療效
黃汝麒、陳偉達、郭昶熹、梁國賢
目的：評估子宮動脈栓塞術（UAE）作治療症狀性纖維子宮肌瘤的香港華籍婦女的功效和安全性。
方法：回顧分析2005年6月至2013年12月期間香港一所分區醫院接受UAE治療的所有患者。她們均在治療前後進行了磁共振成像（MRI）。使用MRI掃描影像計算子宮和肌瘤體積以評估影像學改善。徵狀紀錄包括異常子宮出血、痛經、尿頻和腹脹。
結果：61名患者進行了評估。技術操作成功率98%，僅一個失敗病例。患者中13%接受治療性子宮切除術或子宮肌瘤切除術。平均子宮體積由897.5 ml減至608.4 ml（減幅35.9%）。最大肌瘤的體積從258.7 ml減至169.9 ml（減幅48.9%）。患者症狀包括異常子宮出血（85%）、痛經（86%）和尿頻（82%）均有改善。UAE治療後，56%患者的血紅蛋白水平從100 g/l升至119 g/l。少數患者出現輕微併發症，包括發熱、尿道感染、陰道分泌物和栓塞後綜合徵。3名患者在接受UAE治療後出現永久性閉經。3名患者治療後有肌瘤組織排出，無需住院治療。
結論：本地數據顯示UAE是針對症狀性纖維瘤婦女的一個安全、有效的治療，不但成功率高，纖維瘤體積也縮小。