Experience with collaborative management of symptomatic fibroids by gynecology and interventional radiology

Objective: The purpose of this paper is to review the initial collaborative experience of a gynecologist and an interventional radiologist in the utilization of embolotherapy in the management of symptomatic uterine myomas.Methods: One hundred five consecutive subjects treated by embolotherapy were selected for review. All patients derived from a single gynecologic practice and were evaluated by the same examiner, using standardized criteria. Embolotherapy was carried out in all subjects by the same interventional radiologist using 500-700 µm polyvinyl alcohol particles injected bilaterally into the uterine arteries utilizing uniform technique and endpoints.Results: Size reduction of 20-85% confirmed by follow-up ultrasound was achieved. Ninety percent of patients noted improvement in their overall symptoms. Eighty percent of patients were able to resume normal activity 4 days after therapy, the remainder of 20% within 2 weeks. One patient subsequently underwent hysterectomy. At 1-year follow-up, changes in size and menorrhagia persisted.Conclusion: The collaborative treatment of fibroids by gynecologists and interventional radiologists appears to offer an effective alternative to women with symptomatic uterine fibroids.