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The effectiveness of combined abdominal myomectomy and uterine artery embolization
Author(s) -
McLucas Bruce,
Voorhees William D.
Publication year - 2015
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2015.03.039
Subject(s) - medicine , myoma , uterine artery embolization , hysterectomy , uterine artery , uterine myomectomy , surgery , blood transfusion , retrospective cohort study , leiomyoma , blood loss , uterine fibroids , abdominal hysterectomy , uterus , radiology , obstetrics , pregnancy , gestation , biology , genetics
Objective To evaluate the efficacy of abdominal myomectomy after uterine artery embolization (UAE‐AM) among patients with myomas. Methods In a retrospective study, chart data were reviewed for patients attending a center in California, USA, who underwent UAE‐AM between 1999 and 2012. Patients had been offered the combined procedure if the diameter of the myoma was at least 4 cm, they wished to preserve fertility, or they were candidates for a traditional abdominal myomectomy. Estimated blood loss, fluoroscopy times, and hospital stay were recorded. Follow‐up data on uterine volume and fibroid size had been collected via magnetic resonance imaging or ultrasonography approximately 3–6 months after UAE‐AM. Result Overall, 20 patients underwent UAE‐AM. Approximately 6 months after the procedure, the mean decrease in uterine volume was 77.33% ± 14.25% and that in myoma diameter was 46.45% ± 25.61%. Six women subsequently became pregnant; one patient had two separate pregnancies. No patient required a conversion to hysterectomy or blood transfusion, and no recurrences were reported. Conclusion UAE‐AM was found to be an effective option available to women with large myomas who wished to preserve their uterus. With the combination procedure, patients had favorable outcomes with no fibroid recurrence.