Uterine Artery Embolisation for Giant Fibroids: Does Size Matter?

Background: Studies have suggested UAE in the case of giant fibroids (defined as fibroids ≥10 cm) increases post-procedural risk levels in comparison with smaller fibroids. The aim of this study is to determine the suitability of UAE in cases of giant fibroids and to assess the procedural outcomes and complications. Method(s): Retrospective data was collected for UAEs conducted over a five-year period at a tertiary centre. Patients with pre- and post-procedure MRI studies as well as giant fibroids were included. Alterations in the volume of the uterus and size of the dominant giant fibroid were calculated pre- and post-UAE. Post-UAE complications and surgical interventions were also documented. Patient satisfaction was assessed using the 40-point uterine fibroid symptom quality of life (UFS-QoL) questionnaire. Result(s): Between 2013-2018, 281 female patients underwent UAE. Of these, 24 (8.5%) patients were found to have giant fibroids (mean age 50.8±3.8 years; range: 40-55). The mean pre-UAE uterine volume was 1511.6±517.9 CC, while mean post-UAE uterine volume was 961.4±483.6 CC (p<0.05). The mean giant fibroid size pre-UAE was 13.5±2.6 cm, and post-UAE was 10.3±3.6 cm (p<0.05). 92% of fibroids were effectively devascularised. 16.7% of patients experienced post-UAE pelvic infection. 18.2% patients underwent further surgical intervention. Conclusion(s): UAE is a safe and efficacious treatment option for giant fibroids. The percentage of patients developing post-UAE infection is perhaps higher than quoted average of 2%, given the greater burden of necrotic tissue after giant fibroid embolisation.

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Artikel online veröffentlicht:
11. Mai 2021