Efficacies of uterine artery embolization for symptomatic uterine fibroids using gelatin sponge: a single-center experience and literature review
Authors Toda A, Sawada K, Osuga K, Maeda N, Higashihara H, Sasano T, Tomiyama N, Kimura T
Received 28 February 2016
Accepted for publication 17 May 2016
Published 12 August 2016 Volume 2016:8 Pages 397—404
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Lucy Goodman
Peer reviewer comments 5
Editor who approved publication: Professor Elie Al-Chaer
Aska Toda,1 Kenjiro Sawada,1 Keigo Osuga,2 Noboru Maeda,2 Hiroki Higashihara,2 Tomoyuki Sasano,1 Noriyuki Tomiyama,2 Tadashi Kimura1
1Department of Obstetrics and Gynecology, 2Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
Aim: The aim of this study was to retrospectively analyze the efficacies of uterine artery embolization (UAE) using gelatin sponge for symptomatic uterine fibroids.
Methods: A series of 60 consecutive premenopausal women underwent UAE using gelatin sponge particles or porous gelatin particles. Patients were routinely followed up at 1, 3, 6, and 12 months after the procedure and asked to report any procedure-related complications. At each follow-up, an original clinical questionnaire was completed by the patients to evaluate changes in fibroid-related symptoms. Pelvic magnetic resonance imaging was performed before and at 3 and 12 months after the procedure, and the changes in volume of the dominant fibroid were calculated.
Results: Bilateral UAE was successfully performed in all the patients. Median age was 45 years (range 34–53 years), and median follow-up period was 25.2 months (range 1–116 months). At the 3- and 12-month follow-up, the dominant fibroid volumes were found to be significantly decreased by 33.4% (95% confidence interval [CI]: 24.9–41.1) and 48.4% (95% CI: 40.7–56.1) compared to baseline volumes, respectively. Excluding patients not having menorrhagia or bulk-related symptoms, at 12 months 49 of 50 (98%) women showed improvement in menorrhagia, and 45 of 47 (95.7%) women showed improvement in bulk-related symptoms. During the follow-up period, ten patients (16.7%) required further interventions including two patients who had undergone hysterectomy. No sequelae were experienced by any of the patients.
Conclusion: UAE using gelatin sponge was associated with a high clinical success rate and good fibroid volume reduction compared to UAE using other embolic agents.
Keywords: embolic agent, gelatin sponge, uterine artery embolization, uterine fibroid
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]