For Physicians: Representative Cases

Case 1 | Case 2 | Case 3 | Case 4

49yo BF with a 3yr h/o dysmenorrhea and refractory anemia secondary to severe menometrorrhagia. At one point she bled for 30 consecutive days. She also reported dyspareunia, urinary frequency, and lethargy. On exam her uterus was 20wks gestational size, firm, and lobulated. She was offered hysterectomy but chose UFE instead.

Results: At 6 month follow-up her periods had normalized and other symptoms resolved. Her energy level was dramatically improved. Uterine volume decreased by 55%. There has been no recurrence of symptoms at three years.

Figure 1 : Left uterine artery pre- and post-embolization. Pre-embolization angiogram shows multiple hypervascular fibroids. Following embolization the uterine artery is occluded and contrast refluxes into other internal iliac branches.

Figure 2 : Right uterine artery pre- and post-embolization. Right uterine artery pre- and post-embolization. Pre-embolization angio shows similar hypervascular fibroids. Following embolization the fibroid vessels are occluded with residual flow into normal lower uterine segment branches.

Figure 3 :Sagital MRI Pre- and 6mos post-embolization. Sagital MRI Pre- and 6mos post-embolization. Pre-embolization MRI shows an enlarged uterus containing multiple fibroids compressing the bladder and bowing the abdominal wall. After embolization the uterus has decreased substantially, as have the individual fibroids. Note how abdominal wall is no longer bowed.

Case 1 | Case 2 | Case 3 | Case 4