Background: Uterine artery embolisation (UAE) is an accepted treatment option for the majority
of uterine fibroids. UAE in the case of submucosal fibroids is more contentious given
the potential risk of expulsion of necrotic material. The aim of this study was to
determine the suitability of UAE in cases where submucosal fibroids exist and to assess
the procedural outcomes and complications. Method(s): Retrospective data was collected for UAEs conducted over a five-year period at a
single tertiary centre. Patients with pre- and post-procedure MRI studies as well
as submucosal fibroids were included. Alterations in the volume of the uterus and
size of the dominant submucosal fibroid were calculated pre- and post-UAE. Post-UAE
complications and surgical interventions were also documented. Patient satisfaction
was assessed using the 40-point uterine fibroid symptom quality of life (UFS-QoL)
questionnaire. Result(s): Between 2013-2018, 281 female patients underwent UAE. Of these, 26 (9.3%) patients
were found to have submucosal fibroids (mean age 47.5±5.0 years; range: 35-56). The
mean pre-UAE uterine volume was 986.5±565.1 CC, while mean post-UAE uterine volume
was 666.9±542.0 CC (p<0.05). The mean dominant submucosal fibroid size pre-UAE was
5.3±2.5 cm, and post-UAE was 3.25±2.74 cm (p<0.05). 100% of fibroids were effectively
devascularised. 7.7% of patients experienced post-UAE pelvic infection. 41.2% patients
underwent further surgical intervention, while 58.8% were discharged from clinic.
Conclusion(s): UAE is a safe and efficacious treatment option for submucosal fibroids, however a
high percentage of patients may require adjunctive surgical intervention to augment
therapeutic results.