From: OB GYN News | Date: May 15, 2005 | Author: Johnson, Kate | More results for: less pregnancy risk after uae than suspected

LONDON -- The strongest data yet on pregnancies after uterine artery embolization suggest that the procedure poses less risk to subsequent pregnancies than was previously suspected, according to British researchers.

"It would be scientifically invalid to suggest that no patient wishing to become pregnant in the future should undergo uterine artery embolization [UAE]," said Woodruff J. Walker, M.D., who presented the data at the annual congress of the International Society for Gynecologic Endoscopy.

"This evidence suggests the risks of pregnancy after UAE are less than first feared," commented Franklin D. Loffer, M.D., medical director and executive vice president of AAGL, an association formerly known as the American Association of Gynecologic Laparoscopists.

"This is a very large, long series. And it is the type of information that, as it accumulates, sets opinions," he told this newspaper.

Dr. Walker, an interventional radiologist at Royal Surrey County Hospital in Guild-ford, England, also presented prospective long-term follow-up data on uterine artery embolization (UAE). The prospective study included 174 women who were followed for 5-7 years after undergoing UAE for symptomatic fibroids.

Out of 98 patients who expressed a desire for future pregnancy, 42 reported a total of 53 pregnancies making this the largest series of post-UAE pregnancies from a single center worldwide, Dr. Walker said.

Eighty-seven percent of women said they would recommend the procedure to others, 61% said they were satisfied with the procedure, and 85% reported an improved quality of life.

"In older patients, there is some suggestion that UAE can bring on menopause earlier," he said. In a larger series of 1,200 women, 5 women younger than 45 years have experienced ovarian failure, although 2 had predisposing factors, he added.

Source: Dr. Walker
BY KATE JOHNSON

Montreal Bureau COPYRIGHT 2005 International Medical News Group

AJR 2001; 177:297-302
© American Roentgen Ray Society

All authors: Department of Radiology, A-113, Albany Medical College, 47 New Scotland Ave., Albany, NY 12208.

Received October 2, 2000; accepted after revision February 2, 2001.

This study was performed to evaluate the MR imaging appearance and clinical response of patients undergoing uterine artery embolization for the treatment of menorrhagia due to adenomyosis.

Of the 15 patients in this study, five had diffuse adenomyosis without evidence of uterine fibroids, one had focal adenomyosis without evidence of uterine fibroids, and the remaining nine had adenomyosis with one or more fibroids. At follow-up, 12 of the 13 patients reported significant improvement in presenting symptoms and quality of life. One patient continued experiencing menorrhagia, and one patient experienced amenorrhea during the 5 months of follow-up after embolization.

and junctional zone thickness. Larger prospective studies are needed to establish the safety and efficacy of this procedure for patients with adenomyosis.

In our interventional radiology practice, we noted that many patients referred for uterine artery embolization on the basis of initial sonographic screening studies and clinical symptoms suggestive of fibroids were, in fact, shown to have adenomyosis on preembolization MR imaging of the pelvis. We expected this finding, given the frequent coexistence of adenomyosis and fibroids, their often similar clinical symptoms, and the potential difficulties in identifying adenomyosis at screening sonography

Pelvic MR imaging in all patients revealed a junctional zone thickness greater than 12 mm. The mean—junctional-zone thickness before embolization was 30.4 mm (range, 13-70 mm). Of the 15 patients making up the study population, five had diffuse adenomyosis without evidence of uterine fibroids, one had focal adenomyosis without evidence of uterine fibroids, and nine had adenomyosis (diffuse or focal) with one or more uterine fibroids.