WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

*Ali Ahmed Darib Albaldawi, Khalid Salih Maulood and Ali Husssein Al-Dharob

ABSTRACT

Background: Uterine fibroids, also known as leiomyomas, are benign smooth muscle tumors of the uterus that affect up to 70% of women by the age of 50. Although many fibroids remain asymptomatic, others can lead to a variety of distressing symptoms such as heavy menstrual bleeding, pelvic pain, pressure symptoms, and infertility. Uterine artery embolization (UAE), has emerged as a minimally invasive and effective alternative to surgical interventions such as hysterectomy or myomectomy, particularly for women seeking uterine preservation. Objectives: Is to evaluate uterine artery embolization therapy for pain management and tumor size reduction among patients with symptomatic uterine fibroid. Methods: This is a prospective, observational clinical study carried out at a tertiary care center’s interventional radiology and gynecology departments over a period of 12 months, from the 1st of January 2022 to the end of December 2022. The study included women aged 25–50 years, and diagnosed with symptomatic uterine fibroids which were suitable candidates for UAE as per gynecological and radiological assessment. Pregnant or current breastfeeding ladies, those with known or suspected uterine malignancy or ladies with active pelvic infection, patients with contraindication to contrast media or NSAIDs, previous UAE or recent hormonal therapy within 3 months, were excluded from the study. The questionnaire included four sections. Section one for sociodemographic information of the study participants. Section two for patients’ clinical manifestations. Section three for pain outcomes and section four for size and diameter of the fibroids. Results: Sixty patients included in this study and met the inclusion criteria. The mean age of them was 46.6 ± 5.1 years. Moreover; all of the patients were presented with menorrhagia, with leaser extend for dysmenorrhea, pain, bulky symptoms and obstructive symptoms. On the other hand; the majority of patients had multiple fibroid, fibroid size of 50-80 mm. According to visual analog scale before and after frequent time interval of UAE intervention, it’s evident that pain was improved frequently with progressing of time. Both solitary and multiple uterine fibroid shows statically significant difference (P-value= 0.031 and 0.022) regarding their size reduction before and after receiving UAE intervention, with no statistically significant difference between them regarding their percentage of reduction (P-value = 0.493). Additionally; the study found a statistically significant difference regarding diameter reduction between patients with fibroid size of more than 80 mm in comparison to those lesser diameter (P value <0.001). Conclusion: The current study establishes UAE as a safe and effective alternative to surgery for the treatment of symptomatic uterine fibroids. The impact of fibroid size on UAE outcomes is still being debated, and the current evidence is inconsistent. This study showed that fibroid size or number had little impact on UAE results. This treatment option really ensures a mean uterine fibroid diameter decrease of around 39% after a 1-year follow-up.