Uterine Artery Embolization Using Gelatin Sponge Particles For Symptomatic Focal And Diffuse Adenomyosis

Objective: To evaluate the effectiveness of uterine artery embolization (UAE) with gelatin sponge particles for symptomaticfocal and diffuse adenomyosis. Materials and Methods: This was a retrospective study conducted between January 2014 and December 2019. All women underwent UAE for symptomatic adenomyosis without leiomyomas. Gelatin sponge particles were used in all cases. Patients were assessed for effectiveness of symptom control, changes in uterine volume, and degree of tumor necrosis on magnetic resonance (MR) imaging. Results: One hundred and sixty-three patients underwent UAE. There were statistically significant differences in bleeding score, pain score, and uterine volume at three months after UAE (P < 0 .001, P < 0.001, and P < 0.001, respectively). Complete tumor necrosis occurred in 66.9% of cases after UAE. Proportion of complete necrosis were significantly different in cases with focal adenomyosis compared with diffuse adenomyosis (P =0.023). Symptom recurrence occurred in 20.6% of cases at 12-month follow-up. Focal adenomyosis patients with complete necrosis had no recurrent menorrhagia and dysmenorrhea. No major complications were observed. Conclusions: UAE using gelatin sponge particles is an effective and safe treatment for symptomatic adenomyosis. Patients with focal adenomyosis with complete necrosis after UAE had no symptom recurrence at midterm follow-up.