Download PDF
Semin intervent Radiol 2008; 25(4): 387-393
DOI: 10.1055/s-0028-1102994
© Thieme Medical Publishers

Uterine Artery Embolization for the Treatment of Adenomyosis

Meridith J. Englander1
  • 1Department of Radiology, Albany Medical Center, Albany, New York
Further Information

Publication History

Publication Date:
15 December 2008 (online)

Also available at
    Permissions and Reprints

ABSTRACT

Adenomyosis is a benign uterine disorder that causes menorrhagia and dysmenorrhea. Although it was once considered a contraindication to uterine artery embolization, several authors have examined whether adenomyosis can be treated with uterine artery embolization. This article reviews the pathophysiology of adenomyosis, its imaging characteristics, as well as recent studies evaluating the efficacy of uterine artery embolization for treatment of adenomyosis.

KEYWORDS

Adenomyosis - uterine artery embolization

REFERENCES

  • 1 Azziz R. Adenomyosis: current perspectives.  Obstet Gynecol Clin North Am. 1989;  16 221-235
    PubMedSearch in Google Scholar
  • 2 Bergholt T, Eriksen L, Berendt N, Jacobsen M, Hertz J B. Prevalence and risk factors of adenomyosis at hysterectomy.  Hum Reprod. 2001;  16 2418-2421
    CrossrefPubMedSearch in Google Scholar
  • 3 Wood C. Surgical and medial treatment of adenomyosis.  Hum Reprod Update. 1998;  4 323-336
    CrossrefPubMedSearch in Google Scholar
  • 4 Rokitansky K. Ueber uterusdrüsen–neubildung.  Ztschr Gesellsch Aerzte Wien. 1860;  16 577-581
    PubMedSearch in Google Scholar
  • 5 Bird C C, McElin T W, Manalo-Estrella P. The elusive adenomyosis of the uterus.  Am J Obstet Gynecol. 1972;  112 583-593
    CrossrefPubMedSearch in Google Scholar
  • 6 Ferenczy A. Pathophysiology of adenomyosis.  Hum Reprod Update. 1998;  4(4) 312-322
    CrossrefPubMedSearch in Google Scholar
  • 7 Sandberg E C, Cohn F. Adenomyosis in the gravid uterus at term.  Am J Obstet Gynecol. 1962;  84 1457-1465
    PubMedSearch in Google Scholar
  • 8 Schindl M, Birner P, Obermair A et al.. Increased microvessel density in adenomyosis uteri.  Fertil Steril. 2001;  75 131-135
    Search in Google Scholar
  • 9 Benson R C, Sneeden V D. Adenomyosis: a reappraisal of symptomatology.  Am J Obstet Gynecol. 1958;  76 1044-1066
    CrossrefPubMedSearch in Google Scholar
  • 10 Nishida M. Relationship between the onset of dysmenorrheal and histologic findings in adenomyosis.  Am J Obstet Gynecol. 1991;  165 229-231
    CrossrefPubMedSearch in Google Scholar
  • 11 Ota H, Igarashi S, Tanaka T. Morphometric evaluation of stromal vascularization in the endometrium in adenomyosis.  Hum Reprod. 1998;  13 715-719
    CrossrefPubMedSearch in Google Scholar
  • 12 Nikkanen V, Punnonen R. Clinical significance of adenomyosis.  Ann Chir Gynaecol. 1980;  69 278-280
    PubMedSearch in Google Scholar
  • 13 Kilkku P, Erkolla R, Gronroos M. Nonspecificity of symptoms related to adenomyosis: a prospective comparative survey.  Acta Obstet Gynecol Scand. 1984;  63 229-231
    CrossrefPubMedSearch in Google Scholar
  • 14 Reinhold C, Tafazoli F, Mehio A et al.. Uterine adenomyosis: endovaginal US and MR imaging features with histopathologic correlation.  Radiographics. 1999;  19 S147-S160
    CrossrefPubMedSearch in Google Scholar
  • 15 Reinhold C, McCarthy S, Bret P M et al.. Diffuse adenomyosis: comparison of endovaginal US and MR imaging with histopathologic correlation.  Radiology. 1996;  199 151-158
    CrossrefPubMedSearch in Google Scholar
  • 16 Ascher S M, Arnold L L, Patt R H et al.. Adenomyosis: prospective comparison of MR imaging and transvaginal sonography.  Radiology. 1994;  190 803-806
    PubMedSearch in Google Scholar
  • 17 Dueholm M, Lundorf E, Hansen E S et al.. Magnetic resonance imaging and transvaginal ultrasonography for the diagnosis of adenomyosis.  Fertil Steril. 2001;  76(3) 588-594
    CrossrefPubMedSearch in Google Scholar
  • 18 Goodwin S C, Vedantham S, McLucas B et al.. Preliminary experience with uterine artery embolization for uterine fibroids.  J Vasc Interv Radiol. 1997;  8 517-526
    CrossrefPubMedSearch in Google Scholar
  • 19 Goodwin S C, McLucas B, Lee M et al.. Uterine artery embolization for the treatment of uterine leiomyomata: midterm results.  J Vasc Interv Radiol. 1999;  10 1159-1165
    PubMedSearch in Google Scholar
  • 20 Spies J B, Scialli A R, Jha R C et al.. Initial results from uterine fibroid embolization for symptomatic leiomyomata.  J Vasc Interv Radiol. 1999;  10 1149-1157
    CrossrefPubMedSearch in Google Scholar
  • 21 Ravina J H, Herbreteau D, Ciraru-Vigneron N et al.. Arterial embolisation to treat uterine myomata.  Lancet. 1995;  346 671-672
    CrossrefPubMedSearch in Google Scholar
  • 22 Worthington-Kirsch R L, Popky G L, Hutchins F L. Uterine arterial embolization for the management of leiomyomas: quality-of-life assessment and clinical response.  Radiology. 1998;  208 625-629
    CrossrefPubMedSearch in Google Scholar
  • 23 Lohle P NM, Voogt M J, DeVries J et al.. Long-term outcome of uterine artery embolization for symptomatic uterine leiomyomas.  J Vasc Interv Radiol. 2008;  19 319-326
    CrossrefPubMedSearch in Google Scholar
  • 24 Smith S J, Sewall L E, Handelsman A. A clinical failure of uterine fibroid embolization due to adenomysosis.  J Vasc Interv Radiol. 1999;  10 1171-1174
    PubMedSearch in Google Scholar
  • 25 Walker W J, Pelage J P. Uterine artery embolisation for symptomatic fibroids: clinical results in 400 women with imaging follow up.  BJOG. 2002;  109 1262-1272
    CrossrefPubMedSearch in Google Scholar
  • 26 McLucas B, Perrella R, Adler L. Embolization for the treatment of adenomyosis.  AJR Am J Roentgenol. 2002;  178 1028-1029
    PubMedSearch in Google Scholar
  • 27 Huang J YJ, Kafy S, Dugas A et al.. Failure of uterine fibroid embolization.  Fertil Steril. 2006;  85(1) 30-35
    CrossrefPubMedSearch in Google Scholar
  • 28 Gabriel-Cox K, Jacobson G F, Armstrong M A et al.. Predictors of hysterectomy after uterine artery embolization for leiomyoma.  Am J Obstet Gynecol. 2007;  196(6) 588
    PubMedSearch in Google Scholar
  • 29 Weichert W, Denkert C, Gauruder-Burmester A et al.. Uterine arterial embolization with tris-acryl gelatin microspheres.  Am J Surg Pathol. 2005;  29 955-961
    CrossrefPubMedSearch in Google Scholar
  • 30 Dundr P, Mara M, Maskova J et al.. Pathological findings of uterine leiomyoma and adenomyosis following uterine artery embolization.  Pathol Res Pract. 2006;  202 721-729
    CrossrefPubMedSearch in Google Scholar
  • 31 Siskin G P, Tublin M E, Stainken B F, Dowling K, Dolen E G. Uterine artery embolization for the treatment of adenomyosis: clinical response and evaluation with MR imaging.  AJR Am J Roentgenol. 2001;  177 297-302
    PubMedSearch in Google Scholar
  • 32 Jha R C, Takahama J, Imaoka I et al.. Adenomyosis: MRI of the uterus treated with uterine artery embolization.  AJR Am J Roentgenol. 2003;  181 851-856
    CrossrefPubMedSearch in Google Scholar
  • 33 Toh C H, Wu C H, Tsay P K et al.. Uterine artery embolization for symptomatic uterine leiomyoma and adenomyosis.  J Formos Med Assoc. 2003;  102 701-706
    PubMedSearch in Google Scholar
  • 34 Kim M D, Won J W, Lee C SA. Uterine artery embolization for adenomyosis without fibroids.  Clin Radiol. 2004;  59 520-526
    CrossrefPubMedSearch in Google Scholar
  • 35 Pelage J P, Jacob D, Fazel A et al.. Midterm results of uterine artery embolization for symptomatic adenomyosis: initial experience.  Radiology. 2005;  234 948-953
    CrossrefPubMedSearch in Google Scholar
  • 36 Kitamura Y, Allison S J, Jha R C et al.. MRI of adenomyosis: changes with uterine artery embolization.  AJR Am J Roentgenol. 2006;  186 855-864
    CrossrefPubMedSearch in Google Scholar
  • 37 Lohle P NM, DeVries J, Klazen C AH et al.. Uterine artery embolization for symptomatic adenomyosis with or without uterine leiomyomas with the use of calibrated tris-acryl gelatin microspheres: midterm clinical and MR imaging follow-up.  J Vasc Interv Radiol. 2007;  18 835-841
    CrossrefPubMedSearch in Google Scholar
  • 38 Kim M D, Kim S, Kim N K et al.. Long-term results of uterine artery embolization for symptomatic adenomyosis.  AJR Am J Roentgenol. 2007;  188 176-181
    CrossrefPubMedSearch in Google Scholar
  • 39 Bratby M J, Walker W J. Uterine artery embolisation for symptomatic adenomyosis – mid term results.  Eur J Radiol. 2008;  , In press
    PubMedSearch in Google Scholar
  • 40 Goldberg J. Uterine artery embolization for adenomyosis: looking at the glass half full.  Radiology. 2005;  236 1111-1112
    PubMedSearch in Google Scholar

Meridith J EnglanderM.D. 

Department of Radiology, MC-113, Albany Medical Center

47 New Scotland Avenue, Albany, NY 12208

Email: englanm@mail.amc.edu