E-ISSN: 3023-6215
Long-term efficacy of uterine artery embolization in the treatment of symptomatic uterine fibroids and its effect on ovarian reserve
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Clinical Research
VOLUME: 29 ISSUE: 2
P: 114 - 121
2019

Long-term efficacy of uterine artery embolization in the treatment of symptomatic uterine fibroids and its effect on ovarian reserve

Anatol J Gen Med Res 2019;29(2):114-121
Esra Bahar Gür 1
Mehmet Serkan Gür 2
Ebru Şahin Güleç 3
1. Department of Obstetric and Gynegology, Izmir Katip Celebi University, Izmir, Turkey
2. Department of Radiology, Izmir Katip Celebi University, Izmir, Turkey
3. Department of Obstetric and Gynegology, Saglik Bilimleri University, Tepecik Educational and Resech Hospital, Izmir, Turkey
No information available.
No information available
Received Date: 2019-03-25T12:46:29
Accepted Date: 2019-09-04T10:51:49
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Abstract

INTRODUCTION

The aim of the study was to evaluate the efficacy of uterine artery embolization and its effects on ovarian reserve in the treatment of symptomatic uterine fibroids.

METHODS

In this retrospective cohort study, 36 patients who underwent uterine artery embolization between January 1, 2010 and January 1, 2018 were analyzed before the procedure and at 6 and 12 months after the procedure. Uterus and fibroid volume were evaluated by contrast-enhanced magnetic resonance imaging. Hemoglobin levels and menstrual bleeding changes were investigated before and after the procedure. Pain was evaluated by visual analog scale. Pre- and post-procedure ovarian reserve was measured with anti-müllerian hormone, follicle stimulating hormone and estriol levels. Numerical data were analyzed by one-way ANOVA and categorical data were analyzed by Mc Nemar test.

RESULTS

The mean age was 42.0 ± 5.8 (SD) and the mean follow-up period was 62 ± 7.1 (SD) (13-72) months. None of the patients developed per-op and post-op complications. Only one patient required surgical procedure due to insufficient decrease of fibroid size. At 6 and 12 months postoperatively, dominant fibroids (157.7, 72.8 and 63.3 cm3) and uterine volume (332.2, 265, 229 cm3) were significantly decreased compared to pre-procedure (p <0.05, p <0.05 and p <0.05, p<0.05, respectively). The decrease in VAS scores before and after the procedure was significant (p <0.01, p <0.01). Also, the decrease in the number of patients with heavy mestural bleeding (72.2%, 33.3% and 27.7%) and decrease of Hb levels (11.2 ± 0.2, 12.3 ± 0.1 and 12.7 ± 0.2 g / dL) were significant (p <0.01, p <0.01and p = 0.04; p = 0.03). No significant changes were observed in ovarian reserve tests during the postoperative follow-up.

DISCUSSION AND CONCLUSION

Uterine artery embolization may be a good alternative to surgery in the treatment of symptomatic uterine fibroids with low complications, high efficacy and patient satisfaction. The adverse effects of uterine artery embolization on ovarian reserve could not be demonstrated.

Keywords:
uterin fibroids, embolization, overian reserve
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