Gelfoam in Uterine Artery Embolization for Acquired Symptomatic Uterine Arteriovenous Shunting and Myomas: Insights from a Retrospective Study

Abstract

Objective: To evaluated the clinical and post procedural success rates of gelfoam bilateral Uterine Artery Embolization (UAE) for symptomatic acquired arteriovenous shunting and myomas.

Methodology: A retrospective study was conducted on women of childbearing age at a tertiary referral center Shaheed Mohtarma Benazir Bhutto Institute of Trauma Karachi from January 2022 to June 2023. Outcome was measured at 3 and 6 months, in terms of bleeding, resolution of myoma, reduction in uterine size or both, and relief of pain intensity following the procedure. A paired t-test was conducted to assess the mean difference in the number of pads used between baseline (pre-operative) and 3 and 6 months post-procedure. A p-value of less than 0.05 was considered the threshold for statistical significance.  

Results: Around 46.9% of women found with pain reduction at three months, increasing to 53.1% at six months. Regarding the impact of surgery on the uterus and myoma resolution, 31.3% of patients showed a decrease in uterine size, 25% had reduced myomas, and 37.5% had a reduction in both. The mean number of pads used per day significantly decreased from 15.34/day before the procedure to 8.44/day at three months and 4.88 at six months, as a statistically significant reduction in pad usage between the third and sixth months post-surgery (P=0.001).

Conclusion: The method of gelfoam UAE observed as a safe and effective alternative procedure to myomectomy or hysterectomy to treat symptomatic uterine arteriovenous shunting and myomas with a high technical and clinical success rate and low rate of the complications.