Adenomyosis (ad-uh-no-my-oh-sis) is a painful uterine condition that may be successfully treated with uterine fibroid embolization (UFE).
Adenomyosis is the growth of the uterine lining into the uterine wall,1 and may affect up to 20 percent of women. The condition creates significant symptoms (like heavy menstruation, pelvic pain, and frequent urination) in up to a third of sufferers,2 many of whom find it difficult to continue with their daily activities due to the pain.
This pain can make you feel desperate for some relief. At the same time, the thought of having a hysterectomy, the traditional adenomyosis treatment, might leave you feeling hopeless.
Now, however, women like you can take heart because one of the most minimally invasive fibroid procedures is now being used as an adenomyosis treatment. Called uterine fibroid embolization (UFE), this treatment for fibroid pain is proving itself effective for other uterine conditions as well.
“Although UFE is commonly known as a treatment for uterine fibroids, it can also be used to treat adenomyosis,” explains Dr. Richard Shlansky-Goldberg, MD, Interventional Radiologist and Professor of Radiology, Obstetrics and Gynecology, and Surgery at the Hospital of the University of Pennsylvania in Philadelphia. “Medical therapy is an option, as is hysterectomy—but not every woman wants hormones or surgery, which makes UFE a viable alternative.”
UFE, when used both as a cure for fibroids in the uterus and as an adenomyosis treatment, utilizes real time imaging by an interventional radiologist to guide a catheter through an incision in the wrist or the groin to the uterus. Once there, the interventional radiologist releases embolics into the appropriate uterine arteries in order to block blood flow to the fibroids or to the uterine tissue growing out of place. The tissue then dies, resolving the pain and alleviating discomfort.
If you think that using this uterine fibroids treatment option for adenomyosis sounds too good to be true, consider a study published in the Journal of Vascular and Interventional Radiology. This study was conducted by Dr. M. D. Kim, from Yonsei University College of Medicine in Seoul, Korea, and a team of researchers. This team found that in the 50 women studied who used UFE as an adenomyosis treatment, 75 percent of them experienced a resolution of symptoms that lasted 18 to 48 months after the UFE.1
“The problem with adenomyosis is that it isn’t abnormal tissue growing—like we see with fibroids,” Dr. Shlansky-Goldberg emphasizes. “It’s normal tissue growing in an abnormal place, which can be more difficult to treat, especially if it fills the majority of the uterus.”
One approach to UFE that shows the highest success rate as an adenomyosis treatment is called the “1-2-3 Protocol.” This protocol uses three differently sized particles (small, normal, and large) to block the uterine arteries.
The 1-2-3 Protocol has completely eliminated all of the affected uterine tissue and prevented symptom recurrence for 18 months in 80 percent of patients.2
“If a woman still experiences symptoms immediately after a UFE procedure that has successfully blocked all sources of blood flow to the affected tissue, a second round probably won’t improve her condition,” Dr. Shlansky-Goldberg clarifies. “But if symptoms recur after a few years, it would make sense to take another look. Blood vessels have a way of making new pathways that could redirect blood to affected uterine tissue, causing symptoms to come back.”
UFE as an adenomyosis treatment can be a very wise choice for women looking for a way to get relief from their symptoms without giving up their fertility through a hysterectomy.
“When it comes to the traditional adenomyosis treatment options available, women are often stuck between a rock and a hard place, especially if they don’t want a hysterectomy,” says Dr. Shlansky-Goldberg. UFE is a promising nonsurgical alternative for patients with adenomyosis. The patients who underwent the procedure reported significant improvement in their symptoms and in quality of life.
- Bae, S. H., Kim, M. D., Kim, G. M., Lee, S. J., Park, S. I., Won, J. Y., & Lee do, Y. (2015). Uterine artery embolization for adenomyosis: percentage of necrosis predicts midterm clinical recurrence. Journal of Vascular and Interventional Radiology, 26(9): 1290-1296. doi: 10.1016/j.jvir.2015.04.026
- Kim, M. D., Kim, Y. M., Kim, H. C., Cho, J. H., Kang, H. G., Lee, C., Kim, H. J., & Lee, J. T. (2011). Uterine artery embolization for symptomatic adenomyosis: a new technical development of the 1-2-3 protocol and predictive factors of MR imaging affecting outcomes. Journal of Vascular and Interventional Radiology, 22(4): 497-502. doi: 10.1016/j.jvir.2011.01.426
- McLucas, B., Voorhees Iii, W. D., & Elliott, S. (2015). Fertility after uterine artery embolization: a review. Minimally Invasive Therapy & Allied Technologies, 2: 1-7
- How common is adenomyosis? https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/humrep/27/12/10.1093/humrep/des332/2/des332.pdf?Expires=1489168409&Signature=GVqmsrSq0SgXlLzZhKgZ6JeHU1bq9bWs~11fa3ZWzw4h-nX31XbXQHdN91uiHK-UxLHP1Ldkz~pjgaV7q-XEQZ9v29x9efzB8tlPDvwKzWri~PaIySCywT1XmZbxO6h92JgvPmOv6fBBNn9Mxvvy-rWuciAjRtcNM-atEap1At89cvBrVbux9wL3LtO~Dy663Tf49gX-t-AYCD0eMOoihGLaEn19Qx-CdLQQPZKlnh2dLZMTIKnh9kcs1DQce3tvMghtfqQslBM-2mQSlT-wVgvbUrP7U-DVNgSsrEgHvXTLef6YgMtPJL~~qBIx3kIaJVxM~Dn6D88SFEwPrqh3dA__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q