CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2019; 79(07): 688-692
DOI: 10.1055/a-0893-4807
GebFra Science
Statement/Stellungnahme
Georg Thieme Verlag KG Stuttgart · New York

Uterine Artery Embolization (UAE) for Fibroid Treatment – Results of the 7th Radiological Gynecological Expert Meeting

Article in several languages: English | deutsch
Thomas Kröncke*
1  Department of Diagnostic and Interventional Radiology and Neuroradiology, Universitätsklinikum Augsburg, Augsburg, Germany
,
Matthias David*
2  Department of Gynecology, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
› Author Affiliations
Further Information

Publication History

received 28 February 2019

accepted 19 March 2019

Publication Date:
28 May 2019 (online)

Abstract

Uterine artery embolization (UAE) is a safe and effective organ sparing treatment for fibroid-related symptoms based on a broad range of published evidence including randomized-controlled trials. Indication for treatment by means of UAE are symptomatic uterine fibroids. UAE is an alternative to surgical and medical treatment for uterine fibroids as well as treatment by MRgFUS. This consensus paper covers the structural prerequisites, the criteria for technical and clinical success, contraindications, side effects and complications as well as the role of UAE treatment in women wishing to conceive and gives guidance on radiation safety measures and clinical follow-up.

Key Points
  • The therapeutic aim of UAE for fibroids is the improvement (alleviation) or disappearance of fibroid-related symptoms.

  • The indication for UAE treatment is based on a gynecological examination incl. ultrasound performed by a specialist.

  • UAE is an alternative to surgical or medical therapy of fibroids as well as fibroid treatment by means of MRgFUS, independently of the size and number of fibroids (leiomyoma) or previous surgery.

  • The decision to offer UAE should be based on the wish of the patient and having regard to treatment alternatives, their success rates, limitations and side effects.

  • For women with uterine fibroids who wish to conceive the role of UAE as a treatment options is still not clarified based on the current state of knowledge.

Kernaussagen
  • Ziel der UAE ist die Besserung oder das völlige Verschwinden von myombedingten Beschwerden.

  • Vor der Therapiefestlegung ist die fachärztlich-gynäkologische Untersuchung inkl. Ultraschall notwendig.

  • Die UAE stellt eine Alternative zum operativen und medikamentösen Vorgehen sowie zur Myombehandlung mit fokussiertem Ultraschall dar, unabhängig von Größe und Anzahl der Myome oder Voroperationen.

  • Die Entscheidung über eine UAE sollte unter Berücksichtigung des Patientenwunsches und in Kenntnis der Therapiealternativen, ihrer Erfolgschancen, Grenzen und Nebenwirkungen getroffen werden.

  • Für Patientinnen mit Uterus myomatosus und Kinderwunsch ist die Rolle der UAE als Behandlungsoption auch weiterhin nicht ausreichend geklärt.

* For the participants of the consensus meeting 2019 listed in alphabetical order at the end of the article.