UAE effective in small study of women with adenomyosis.(News)

NICE, FRANCE -- Uterine artery embolization should not be withheld from women with adenomyosis, according to investigators who conducted a prospective, multicenter study in 42 symptomatic patients.

At a median clinical follow-up of 17 months, 37 women had avoided hysterectomy, Paul N.M. Lohle, M.D., reported at the annual meeting of the Cardiovascular and Interventional Radiological Society of Europe.

Pain, bleeding, and mass-related symptoms were improved or resolved in nearly all patients, said Dr. Lohle of St. Elisabeth Hospital in Tilburg, the Netherlands.

Magnetic resonance imaging attested to the effectiveness of embolization in these patients at a median of 12 months. The data presented included median decreases of 45% for uterine volume, 72% for fibroid volume, and 23% for adenomyosis junctional zone thickness. Investigators claimed a technical success rate of 100% for all 42 bilateral embolizations.

"Therefore, it seems unjustified to withhold [from] women an embolization treatment based on the presence of adenomyosis associated with fibroids," Dr. Lohle said. He urged that larger studies be conducted with longer follow-up.

Speaking on behalf of collaborators at St. Elisabeth Hospital and at Charite University Hospital in Berlin, Dr. Lohle said they conducted the study because they were not convinced by reports of poor clinical outcomes from embolization in the presence of adenomyosis. He described much of the evidence as anecdotal, whereas he said the results of clinical studies ranged from disappointing to encouraging.

Among possible explanations for poor experiences, Dr. Lohle said, is the fact that magnetic resonance imaging is not always used to diagnose adenomyosis, nor are contrast MRIs always used to check the infarction rate. In addition, he said ...