Intermediate and long term clinical effects of uterine arterial embolization with sodium alginate microspheres in treatment of diffuse adenomyosis

OBJECTIVE: To study intermediate and long term efficacy of uterine arterial embolization (UAE) with sodium alginate microspheres (KMG) at diameters 500-00 microm in treatment of diffuse adenomyosis. METHODS: Totally 40 patients with standard diffuse adenomyosis were enrolled and treated with UAE. KMG at diameters 500-700 microm for vascular embolization were used to embolize the arteries. The degree of dysmenorrhea, amount of menorrhea and uterine volume, as well as the level of serum CA125, follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) were investigated before and after UAE. RESULTS: The follow up rates were 100% (40/40), 100% (40/40), 80% (32/40), 68% (27/40), 58% (23/40) after uterine arterial UAE 12, 24, 36, 48 and 60 months respectively. The early, intermediate and long-term effective rates were 90% (36/40), 88% (28/32), 83% (19/23). The degree of dysmenorrhea, the amount of menorrhea and the uterine volume, as well as serum CA125 all decreased significantly 3 months after UAE at varying degrees (P < 0.05). Compared with other follow-up time, the degree of dysmenorrhea and the amount of menorrhea declined to their lowest point at 6 month after UAE (P < 0.01). Paralleled with the decrease of volume of uterine, serum CA125 also decreased significantly and reached the lowest level 12 months later compared with other follow-up times (P < 0.01). Even at the 12th month after UAE serum CA125 was not normal and FSH, LH and E2 did not change all the times after UAE, (P > 0.05). No recurrence was found during the 60 months after UAE. CONCLUSION: KMG used in UAE at diameters 500-700 microm has good intermediate and long term effectiveness in treatment of diffuse adenomyosis with no side effects.