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Utero-ovarian anastomoses and their influence on uterine fibroid embolization.

Abstract

PURPOSE
To correlate clinical outcomes after uterine artery embolization (UAE) performed to treat uterine fibroids with the presence of varying types of utero-ovarian anastomoses (UOA).
MATERIALS AND METHODS
A retrospective analysis was performed of all uterine angiograms from 202 patients (mean age 42 y, range 28-54 y) who underwent UAE because of heavy menstrual bleeding, dysmenorrhea, or anemia or a combination of these symptoms. UOA were classified as absent or present, unilateral or bilateral. The effects of UOA on long-term outcomes (clinical endpoints such as control of bleeding and pain) and complications (amenorrhea) were assessed statistically using Kaplan-Meier curves and χ(2) and log-rank tests.
RESULTS
Of the UOA in 104 women, 38 anastomoses were bilateral, and 66 were unilateral. Type III was the most common type of anastomosis (66 cases) followed by type Ia (22 cases) and type Ib (18 cases); there were no type II anastomoses. Amenorrhea was reported in 27 (14%) women at 5-year follow-up after UAE (only 3% in women < 45 y old). There were 10 cases of clinical failure with a median follow-up of > 4 years. Bilateral or unilateral presence of UOA had no statistically significant effect on outcomes or on complications.
CONCLUSIONS
Recurrence rates, clinical failure, and amenorrhea after UAE do not seem to be influenced by the presence or absence of UOA. However, further studies are needed to confirm these findings.

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  • Publisher Full Text
  • Authors

    Lanciego C, Diaz-Plaza I, Ciampi JJ, Cuena-Boy R, Rodríguez-Martín N, Maldonado MD, Rodriguez-Gómez O, Cañete ML, García-García L

    Source

    Journal of vascular and interventional radiology : JVIR 23:5 2012 May pg 595-601

    MeSH

    Adult
    Amenorrhea
    Chi-Square Distribution
    Collateral Circulation
    Female
    Humans
    Kaplan-Meier Estimate
    Leiomyoma
    Middle Aged
    Odds Ratio
    Ovary
    Pain
    Recurrence
    Regional Blood Flow
    Retrospective Studies
    Risk Assessment
    Risk Factors
    Spain
    Time Factors
    Treatment Outcome
    Uterine Artery
    Uterine Artery Embolization
    Uterine Hemorrhage
    Uterine Neoplasms

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22440591