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Uterine artery embolisation for symptomatic fibroids: the effect of the large uterus on outcome

  1. A. Prollius1,*,
  2. C. de Vries2,
  3. E. Loggenberg2,
  4. A. du Plessis1,
  5. M. Nel3,
  6. P.H. Wessels1

Article first published online: 16 JAN 2004

DOI: 10.1046/j.1471-0528.2003.00019.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 111, Issue 3, pages 239–242, March 2004

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How to Cite

Prollius, A., de Vries, C., Loggenberg, E., du Plessis, A., Nel, M. and Wessels, P.H. (2004), Uterine artery embolisation for symptomatic fibroids: the effect of the large uterus on outcome. BJOG: An International Journal of Obstetrics & Gynaecology, 111: 239–242. doi: 10.1046/j.1471-0528.2003.00019.x

Author Information

  1. 1

    Department of Obstetrics and Gynaecology, University of the Free State, Bloemfontein, South Africa

  2. 2

    Department of Radiology, University of the Free State, Bloemfontein, South Africa

  3. 3

    Department of Biostatistics, University of the Free State, Bloemfontein, South Africa

* *Dr A. Prollius, Department of Obstetrics and Gynecology, University of the Free State, PO Box 339 (G71), Bloemfontein 9300, South Africa.

Publication History

  1. Issue published online: 16 JAN 2004
  2. Article first published online: 16 JAN 2004

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Objective  The aim of this study was to evaluate the efficacy of uterine artery embolisation (UAE) in myomatous uteri larger than 24 week's gestation (780 cm3).

Design  Prospective case contro study.

Setting  Universitas Hospital, University of the Free State, Bloemfontein, South Africa.

Population  Sixty-one women, who underwent UAE, were included in the study. The study group comprised of 12 women with uteri ≥780 cm3 and the control group 49 women with uteri <780 cm3.

Methods  UAE was performed and the difference in outcome for the two groups was determined at 12 months.

Main outcome measure  Symptomatic improvement with embolisation of the large uterus.

Results  Reduction of dysmenorrhoea, menorrhagia and pressure effects was similar for both groups. The median reduction in uterine volume (pre- to post-embolisation) was 188 cm3 (range 28–2038 cm3) with a 95% CI for the median difference for paired data of 146.5 and 236. Only 66% of the study group had, however, a reduction in volume to <780 cm3. The complication rates were similar for the two groups with regards to post-embolisation syndrome, fibroid slough, haematoma formation, infection, hysterectomy and failure to embolise. Satisfaction was similar between the two groups, with 91% of women satisfied with the procedure.

Conclusion  The large uterus does not decrease UAE's efficacy. Although 33.3% of the study group still had a uterus of ≥780 cm3, symptom reduction was still similar for both groups. Women may thus still be left with a large uterine volume but without symptoms. This must be taken into consideration when counselling women with an extremely large uterus for UAE.

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