Surgery may not be the only way to relieve the symptoms of adenomyosis – a condition where endometrial tissue, which normally forms the inner lining of the uterus, instead grows within the uterine muscle wall. Often managed with hysterectomy, the abnormal spread of this tissue can cause heavy menstrual bleeding and severe, debilitating pain. Although conservative treatments like hormone therapy can ease symptoms, many women with adenomyosis must choose between major, life-changing surgery or living with their symptoms. Now, researchers have shown that the minimally invasive procedure known as uterine artery embolization, or UAE, is a promising non-surgical treatment option.
During UAE, a catheter is inserted into the groin and then guided to the uterine arteries , which supply blood to the uterus. Tiny plastic particles are then injected to block blood flow. Because healthy uterine tissue can readily recruit new blood vessels, it isn’t harmed by this blockage. The abnormal tissue produced by adenomyosis, however, doesn’t have this ability and dies due to a lack of oxygen. Only local anesthesia and an overnight hospital stay are required for the procedure, making it far less invasive than surgery.
To determine the impact of UAE on adenomyosis symptoms, the researchers studied data from 117 women who underwent the procedure. The women were followed up for 2 years. At each follow-up, they scored their overall satisfaction with the procedure, level of menstrual bleeding, level of pain and quality of life.
Eighty-nine percent of the women were happy or very happy with their outcomes. Eighty-eight percent reported no longer experiencing heavy menstrual bleeding, and 90% found significant relief from period pain. Quality of life also improved after UAE: the group’s overall score for this factor doubled by the end the study. Moreover, the procedure was safe, producing only mild complications in a handful of participants.
These findings show that UAE is an effective non-surgical option for women who have failed conservative treatment of adenomyosis symptoms . Although studies with longer follow-up times are still needed to demonstrate long-term success following UAE, the technique seems to be a promising alternative to hysterectomy.