Interventionell-radiologische Therapie des Uterusmyoms durch Embolisation

Background: Leiomyomas of the uterus are the most common benign tumors of the pelvic region and occur in approximately 70 % of women. Approximately one third of leiomyomas become symptomatic. Therapeutic approaches include surgical resection and minimally invasive procedures performed by interventional radiologists. Objectives: Presentation of indications, technique, complications and results from uterine artery embolization (UAE) as a minimally invasive therapeutic option for patients with symptomatic uterine fibroids. Material and methods: Evaluation and presentation of the current literature regarding UAE for symptomatic uterine fibroids. Results: The UAE approach provides high technical success rates of up to 98 %. Major complications occur in 3 %. An important predictor for clinical success is represented by the degree of fibroid infarction. Clinical success rates are initially approximately 75 % but reembolization interventions can increase the success rate. In comparison with surgical approaches, secondary interventions are necessary more frequently after UAE. In the long-term both UAE and surgical therapies do not differ regarding quality of life, symptom control and patient satisfaction with the therapeutic result. Conclusion: The UAE represents an effective, minimally invasive treatment option for symptomatic uterine fibroids and should be considered when patients are counseled on different therapeutic approaches. The less invasive character of UAE needs to be balanced against a higher rate of reinterventions.