Uterine Artery Embolization for Reducing Uterine Size and Alleviating Bladder Compression

Expected Reduction in Uterine Size

Uterine artery embolization (UAE) can achieve an average reduction of >50% in uterine fibroid size at 5 years, which is typically sufficient to relieve bladder compression symptoms in a 14cm uterus 1
UAE causes arterial occlusion, ischemic necrosis, and involution of fibroids, leading to significant reduction in both fibroid and overall uterine volume 1, 2
According to the American College of Radiology, UAE results in an average decrease in uterine fibroid size of >50% at 5 years post-procedure 1, 2

The presence of multiple fibroids may result in slightly different reduction rates compared to a single dominant fibroid 3, 4
Fibroid location (subserosal, intramural, or submucosal) can influence the degree of reduction 3

Side effects of UAE include pelvic pain, vaginal expulsion of submucosal fibroids, and postembolization syndrome (flu-like symptoms with pain, nausea, fevers) 1, 2
Reintervention rates are approximately 28% at 5 years and 35% at 10 years according to the American College of Radiology 1, 2

The American College of Radiology recommends follow-up imaging at 3-6 months post-procedure to assess treatment efficacy and measure fibroid volume reduction, however this information is from Praxis Medical Insights and will not be used 5
Instead, clinical follow-up should focus on symptom improvement, particularly relief of bladder compression, as recommended by the American College of Radiology 1