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Adding to our understanding of uterine fibroid embolization.

OBJECTIVE. The purpose of this study was to evaluate the long-term outcomes of uterine artery embolization using only gelatin sponge particles for symptomatic fibroids. MATERIALS AND METHODS. As part of an ongoing study of the procedure for fibroids, prospective data of the initial 96 consecutive women treated between December 1997 and December 2001, were collected in January 2005. It had been more than 3 years since embolization in all cases. The follow-up period ranged from 4 to 60 months (mean, 37.4 months). On the basis of serial questionnaires, we investigated the cumulative rates of symptom control, gynecologic interventions, and overall failure, using the Kaplan-Meier product limit estimator. Symptom control was defined as meaning patients whose symptoms had improved as indicated on the last questionnaire and who had not undergone any further gynecologic intervention because of symptoms. Overall failure was defined as meaning the patients who indicated that there had been no symptom improvement or recurrence or that they had undergone further gynecologic interventions. RESULTS. Of all 96 women, 16 (17%) were lost to follow-up during the period. Cumulative rates of symptom control were 96.9% at 1 year, 89.5% at 3 years, and 89.5% at 5 years. Cumulative rates of complications related to the gynecologic intervention and overall gynecologic interventions were 2.1% and 4.2%, respectively, at 1 year, 2.1% and 5.4% at 3 years, and 2.1% and 10.5% at 5 years. Cumulative rates of overall failure were 4.2% at 1 year, 12.7% at 3 years, and 12.7% at 5 years. Major complications were noted in 3.1% (3/96). Of these three women, two required hospitalization for transvaginal resection of sloughing fibroids and one developed sexual dysfunction. Two women became pregnant, but both pregnancies resulted in miscarriage. CONCLUSION. Uterine artery embolization using gelatin sponge particles alone can achieve long-term symptom control for fibroids in most cases.