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Uterine Artery Embolization Using Gelatin Sponge Particles in Patients with Symptomatic Uterine Fibroids: A
Arsalan Nadeem1, Ali Husnain2, Zain Ali Nadeem3
1Department of Medicine, Allama Iqbal Medical College, Allama Shabbir Ahmad Usmani Road, Lahore, 54700, Pakistan. arsalannadeemh@gmail.com.
Purpose:
To assess the efficacy and safety of uterine artery embolization (UAE) using gelatin sponge (GS) particles through a systematic review and meta-analysis.
Materials And Methods:
PubMed, Embase, Scopus, and Google Scholar were searched from inception to April 2024. Prospective and retrospective nonrandomized studies using GS particles for UAE in leiomyoma patients were included. Outcomes included dominant leiomyoma volume reduction and improvement in menorrhagia, dysmenorrhea, and bulk-related symptoms.
Results:
Six studies with 429 participants were included. Three out of six studies compared GS to another embolic agent. Mean dominant leiomyoma volume reduction was 42.17% at 3 months (95% CI 33.65-50.68%), 53.37% at 6 months (95% CI 47.89-58.86%), and 58.71% at 12 months (95% CI 47.38-70.04%). Menorrhagia improved in 88% (95% CI 85-91%) at 3 months, 95% at 6 months (95% CI 70-100%), and 98% at 12 months (95% CI 92-100%). Dysmenorrhea improved in 90% at 3 months (95% CI 53-100%), 96% at 6 months (95% CI 66-100%), and 89% at 12 months (95% CI 61-100%). Bulk-related symptoms improved in 90% at 3 months (95% CI 74-99%) and 99% at 6 (95% CI 92-100%) and at 12 months (95% CI 95-100%). Amenorrhea was the most common adverse event. Other adverse events included deep venous thrombosis, groin hematomas, fibroid passage, symptom recurrence, anemia, postembolization syndrome, and elevated liver enzymes.
Conclusion:
UAE using GS particles is a potentially effective treatment option for managing uterine leiomyoma. It reduces leiomyoma volume and improves menorrhagia, dysmenorrhea, and bulk-related symptoms.
Level Of Evidence:
Level 2a, Systematic Review & Meta-Analysis of Cohort Studies.
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