Clinical Research Of Uterine Artery Embolization For Symptomatic Hysteromyoma

Objective:To investigate the therapeutic effect of uterine artery embolization (UAE) in treatment of symptomatic hysteromyoma.Materials and Methods:Under the guidance of X-ray, the selective uterine artery embolization (UAE) were done in 50 Patients with symptomatic hysteromyoma who were diagnosed by gynaecologist and measured by sonography. Embolizing agents include Polythene vinyl alcohol(PVA), Pingyangmycin, super lipiodol emulsion and gelatin sponge particles. To measure the patients' hysteromyoma and uterine volume, the level of hormone about ovary(E2,FSH,LH), the amount of menses and protoferriheme before UAE, to compare the change of the patients' clinical symptoms before and after UAE.50 patients were followed up for 3,6,12 months about their hysteromyoma and uterine volume, the level of hormone about ovary(E2,FSH,LH) and complication after UAE.Results:50 patients with symptomatic hysteromyoma were performed with UAE,the average 42.6±3.7 years. The success rate of uterine artery angiography was 100%(50/50). Angiography revealed a rich blood supply of 47 cases patents' uterine fibroids by bilateral uterine artery,3 cases patents'uterine fibroids were supplied by single uterine artery. Bilateral uterine arteries were embolized after UAE, the clinical symptoms were obviously improved, and patients returned to normal menstrual cycle, anaemia were improved(P<0.05).The average volume of hysteromyoma before UAE is 61.0±17.2cm3, the average volume of womb before UAE is 340.4±31.5 cm3. After UAE 50 patients were followed up for 3,6,12 months, the remission rate of uterine volume was 38.2%,46.7%,49.7%, the remission rate of hysteromyoma was 32.1%,65.9%,74.8%. There is a statistical significant(P<0.05) comparing with pro-UAE. The total effective rate was 94% 12 months after UAE. There was post embolization comprehensive symptom including pain(40/50), fever(38/50), gastrointestinal symptom (24/50), vagino bleeding (43/50) 1 week after UAE, the symptom disappeared after being treated. Except that 1 case was menostasis, there were no serious complications such as hysteritis and pus from infected hysteromyoma. To compare the level of hormone about ovary(E2,FSH,LH) before UAE and 3,6,12 months after UAE, there was no statistical significant difference(P>0.05).Conclusion:The clinical symptoms of Symptomatic hysteromyoma were obviously improved by UAE, no serious complications occurred,50 patients' hysteromyoma and uterine volume were shrink. It can protect the normal function of womb and hormone, avoiding injury from the traditional surgeon. UAE was an effective way and minimally invasive treatment for symptomatic hysteromyoma with few complications. UAE is a new treatment for symptomatic hysteromyoma.