Uterine artery embolization for the treatment of symptomatic adenomyosis: a systematic review.
Uterine artery embolization linked to symptom improvement in most adenomyosis patients
Uterine artery embolization for the treatment of symptomatic adenomyosis: a systematic review.
Adenomyosis is a benign uterine condition characterized by the presence of glands and endometrial stroma in the myometrium, with hypertrophy of the smooth muscle cells and uterine enlargement, and causing chronic pelvic pain, dysmenorrhea, and abnormal uterine bleeding, resulting in significant impairment of quality of life.
This systematic review aims to evaluate the efficacy and safety of uterine artery embolization in patients with symptomatic adenomyosis.
Eligible articles included prospective and retrospective observational cohort studies with more than ten patients reporting uterine artery embolization outcomes for adenomyosis; case report, case series, narrative or systematic review, meta-analysis, and guidelines were considered as not eligible and were therefore excluded.
Twenty-two studies met the inclusion criteria and we collected data on 1701 patients who underwent uterine embolization for therapy-resistant adenomyosis.
Imaging assessments showed reductions in uterine volume and junctional zone thickness; reintervention and hysterectomy rates were low.
Reported complications were predominantly minor, with a low incidence of major adverse events.
The mortality rate post-procedure was 0%.
Based on available literature, uterine artery embolization represents a safe and effective uterus-preserving minimally invasive treatment for selected patients with symptomatic adenomyosis; it represents a step on the treatment pathway before hysterectomy, and women should have access to consult with interventional radiologists when making any treatment decision, in order to achieve a personalized treatment plan.