Uterine Fibroid embolization North Manchester Hospital Experience
UAE is a non-surgical treatment for symptomatic fibroids . Ravina et al. first used arterial embolization to treat fibroids ,publishing their series in 1991
Uterine fibroids are common benign tumors in women of reproductive age. They are frequently associated with menorrhagia, pelvic pain, and bulk-related
symptoms.
While surgical options remain the mainstay of treatment, Uterine Artery Embolization (UAE) offers a minimally invasive, uterus-preserving alternative.
UAE induces fibroid shrinkage through vascular occlusion, with symptom relief often correlating with reductions in fibroid volume.
NICE recommended the procedure for management of symptomatic fibroids including heavy menstrual bleeding, dysmenorrhoea, dyspareunia and pressure effects.
•This was a retrospective audit review of clinical records specifically designed for UAE women. The clinical data were collected in a standarrdised format from HIVE. 32 women had the procedure performed between 2021 to 2024. Women with symptomatic fibroids referred from the community were counselled regarding the treatment options as per NICE guidance. MRI scan reviewed by the interventional radiologist to confirm suitability of the procedure following appropriate counselling. Our clinical outcome regarding menorrhagia, pain, pressure symptoms, reduction in size of the fibroids were reviewed at follow up
•Age of the women ranged form 37-57 years with a median age 46.Parity ranged from P0-P5. Presenting complaints 32/32 complained of menorrhagia with symptomatic anemia, 9/32 complained of pain, and 10/32 complained of pressure symptoms 9/32 complained of urgency of micturition. 5/32 women had been given Gnrh analogues for medical management of fibroids. None of the women referred had any surgical treatment for fibroids prior to UFE. The fibroids were mapped predominantly intramural fibroids some multiple fibroids. The largest fibroid where uterus measured 24 weeks size with largest fibroid 19.5 cms.
•The average fibroid size before and after treatment was 6.0 cm and.5 cm respectively.
•The mean reduction in fibroid size was 1.46 cm Off the 36 fibroids, 30 fibroids had a reduction in size (81%). 4 fibroids had no change in size and 2 fibroids increased in size. Among those with early follow-up, 50% showed either complete resolution or significant improvement in symptoms
•In our cohort of patients fibroid expulsion needing excision or myomectomy in 2/32 (6.25%). Thrombosis 1/32( 3%), malignancy diagnosed post procedure 1/32,
•In 4/32 there was no change in the size of the fibroid, however on average there was 25% reduction in the size of fibroids. 1/32 needed repeat UAE after 9 months follow up. Reduction in symptoms of amenorrhoea and pain were seen in over 80% of women
•Conclusion:
•UAE is a safe and highly effective treatment for women with symptomatic fibroids and/or adenomyosis. The procedure was safe, and there were no significant procedural-related complications, minimally invasive procedure confers the advantage of decreased hospital stay and safe alternative to surgery
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