Hong Kong Med J 2006;12:361-7 | Number 5, October 2006
Uterine fibroid embolisation in Chinese women: medium-term results
HLJ Mak, PCH Kwok, HHL Chau, MK Chan, SCH Chan, SCS Chan
Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong
OBJECTIVE. To evaluate the medium-term results of uterine fibroid embolisation in Chinese women with symptomatic uterine fibroids.
DESIGN. Prospective case series study.
SETTING. Gynaecology and Interventional Radiology units in a public hospital, Hong Kong.
PATIENTS. Patients with symptomatic fibroids who underwent uterine fibroid embolisation in Queen Elizabeth Hospital from October 1998 to June 2004.
RESULTS. Fifty women (mean age, 42.9 years, median follow-up period, 27.5 months) were recruited. Most (82%) had menorrhagia as the chief presenting symptom. Embolisation was successful in 49 (98%) women. Complications occurred in 12 (24%) patients, but were all self-limiting. Significant decrease in the median clinical uterine size (14 weeks vs 10 weeks) and median volume of the largest fibroid on magnetic resonance imaging (157.9 mL vs 45 mL) were observed during the first year. The reduction seemed to be maintained till the last follow-up. Menorrhagia improved in 34 (84%) patients, dysmenorrhoea in 28 (88%), pelvic pain in 18 (82%) and abdominal mass in 15 (83%). Poor response was found for urinary symptoms (29% improvement). Eight (16%) patients underwent hysterectomies after uterine fibroid embolisation. On logistic regression analysis, the only significant predictive factor for symptomatic improvement was fibroid volume reduction at 6 months (P=0.03).
CONCLUSION. Uterine fibroid embolisation is an effective uterine-preserving therapy in patients with symptomatic fibroids; overall symptomatic improvement was estimated as 80%. Uterine or fibroid size reduction correlated well with clinical outcome. The impact of uterine fibroid embolisation on young women wishing to conceive is yet to be determined.
Key words: Embolization, therapeutic; Leiomyoma; Magnetic resonance imaging; Uterus; Women
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