Uterine Artery Embolization Improves Quality of Life in Patients with Pure Adenomyosis: A Single‑Center Experience

Ibrahim Alrashidi; Hayat Alharthy; Faisal Alahmari; Sultan Alammari; Hatim Alobaidi; Abdulwaeed Alruhaimi; Abdulaziz Almat'hami; Abdulrahman Alkhalifah; Fares Garad

doi:10.4103/AJIR.AJIR_30_19

The Arab Journal of Interventional Radiology, Table of Contents

CC BY-NC-ND 4.0 · The Arab Journal of Interventional Radiology 2020; 4(02): 117-120
DOI: 10.4103/AJIR.AJIR_30_19

Original Article

Uterine Artery Embolization Improves Quality of Life in Patients with Pure Adenomyosis: A Single‑Center Experience

Authors

Ibrahim Alrashidi

Department of Radiodiagnostics and Medical Imaging, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
Hayat Alharthy

Department of Obstetric and Gynecology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
Faisal Alahmari

Department of Radiodiagnostics and Medical Imaging, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
Sultan Alammari

Department of Radiodiagnostics and Medical Imaging, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
Hatim Alobaidi

Department of Radiodiagnostics and Medical Imaging, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
Abdulwaeed Alruhaimi

Department of Radiodiagnostics and Medical Imaging, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
Abdulaziz Almat'hami

Department of Radiodiagnostics and Medical Imaging, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
Abdulrahman Alkhalifah

Department of Radiodiagnostics and Medical Imaging, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
Fares Garad

Department of Radiodiagnostics and Medical Imaging, Prince Sultan Military Medical City, Riyadh, Saudi Arabia

Abstract

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Aim: The aim of the study was to assess clinical outcomes following uterine artery embolization (UAE) in the treatment of dysmenorrhea and menorrhagia related to pure adenomyosis. Materials and Methods: This was a retrospective analysis of 14 patients with dysmenorrhea and menorrhagia related to pure adenomyosis treated with UAE using polyvinyl alcohol (PVA) between January 2017 and September 2019. The baseline and 3-month and 12-month postintervention outcomes were assessed using Uterine Fibroid Symptom-Health-Related Quality of Life Questionnaire (UFS-QOL), Symptom Severity Score (SSS), and magnetic resonance imaging findings. The median age of the patients was 47 years (28–55). The main clinical presentation was dysmenorrhea and menorrhagia, with a median duration of symptom of 24 (12–84) months. All patients received combined estrogen-progestin and nonsteroidal anti-inflammatory drugs prior to UAE without clinical improvement. Results: According to UFS-QOL and SSS results, the score for distress level was statistically significantly reduced from baseline 4.6 (3.6–5) to 2.25 (1–3.37) (P = 0. 018) after 3 months, and remained stable 12 months later. The score of symptom level was statistically significantly reduced from 4 (3.6–5) at baseline to 1.6 (1–3.58) (P = 0. 018) after 3 months with maintained clinical satisfaction after 12-month follow-up. The junctional zone was statistically significantly reduced from baseline with a median of 33.5 mm (19–79 mm) to 25 mm (8–77 mm) after 3 and 12 months (P = 0.046). The incidence of post-UAE permanent amenorrhea is 71% with a mean age of 49 years. No patient underwent hysterectomy during the follow-up period. Conclusion: UAE using PVA can improve the quality of life in patients with menorrhagia and dysmenorrhea related to adenomyosis. However, larger prospective studies are needed to establish the long-term outcomes and risk of amenorrhea.

Adenomyosis - dysmenorrhea and uterine fibroid symptom and health-related quality of life - menorrhagia - uterine artery embolization

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References

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