Uterine Artery Embolization Using Gelatin Sponge Particles in Patients with Symptomatic Uterine Fibroids: A...

Area of Science:

• Gynecologic Surgery
• Interventional Radiology
• Reproductive Medicine

Background:

• Uterine leiomyomas (fibroids) are common benign tumors affecting women of reproductive age.
• Uterine artery embolization (UAE) is a minimally invasive procedure used to treat symptomatic leiomyomas.
• Gelatin sponge (GS) particles are an embolic agent used in UAE, but their efficacy requires systematic evaluation.

Purpose of the Study:

• To systematically review and meta-analyze the efficacy and safety of UAE utilizing gelatin sponge (GS) particles for treating uterine leiomyomas.
• To assess the impact of GS particle UAE on leiomyoma volume reduction and symptom improvement.

Main Methods:

• A systematic review and meta-analysis of prospective and retrospective nonrandomized studies was conducted.
• Searches were performed across PubMed, Embase, Scopus, and Google Scholar up to April 2024.
• Included studies focused on UAE with GS particles in leiomyoma patients, evaluating outcomes such as dominant leiomyoma volume reduction and symptom relief.

Main Results:

• Six studies involving 429 participants were analyzed, with three comparing GS to other embolic agents.
• Significant dominant leiomyoma volume reduction was observed: 42.17% at 3 months, 53.37% at 6 months, and 58.71% at 12 months.
• High rates of symptom improvement were reported: menorrhagia (88% at 3 months to 98% at 12 months), dysmenorrhea (90% at 3 months to 96% at 6 months), and bulk-related symptoms (90% at 3 months to 99% at 6-12 months).
• Amenorrhea was the most frequent adverse event, with other reported complications including DVT, hematomas, and symptom recurrence.

Conclusions:

• Uterine artery embolization using gelatin sponge particles demonstrates considerable efficacy in managing uterine leiomyomas.
• The procedure leads to substantial reduction in leiomyoma volume and significant improvement in patient-reported symptoms.
• UAE with GS particles represents a viable and effective treatment option for women suffering from symptomatic uterine leiomyomas.