Efficacy of Uterine Artery Embolization (UAE) in Management of Symptomatic Uterine Adenomyosis
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 30
- 主要终点
- Management of symptomatic uterine adenomyosis
研究概览
简要总结
Aim of the work:
Evaluating the efficiency of uterine artery embolization as a minimally invasive method of treatment in management of symptomatic women with uterine adenomyosis
详细描述
Adenomyosis is defined as a non-neoplastic disease, caused by benign invasion of the myometrial layer by endometrial tissue, associated with myometrial smooth muscle hyperplasia. This ectopic endometrium shows two main patterns of distribution in the myometrium: either focal endometrial implant of endometrial glands, or diffuse invasion of the myometrium. Uterine enlargement is often seen with diffuse adenomyosis, while in cases with focal adenomyosis, characteristic feature in ultrasound (US) can be misdiagnosed as leiomyoma, appearing as focal heterogeneous myometrial thickening or myometrial cysts.
Usually, adenomyosis is presented with dysmenorrhea, menorrhagia, and abnormal uterine bleeding. Previously, adenomyosis was diagnosed in multiparous women older than 40 years, causing abnormal uterine bleeding (AUB). But recently, it has been widely recognized among larger group, including nulliparous women earlier in reproductive life, owing to increased availability and better imaging techniques.
The first imaging modality to diagnose adenomyosis is transabdominal sonography (TAS) or transvaginal sonography (TVS). While magnetic resonance (MR) imaging is considered the gold standard diagnosis method due to its accuracy; being noninvasive modality and its ability for better soft tissue characterization to differentiate adenomyosis from other pathologies.
First line of management of adenomyosis include medications as non-steroidal anti-inflammatory drugs and/or hormonal therapy. Yet, other methods of treatment are needed in different cases.
For many years, the most common line of treatment for symptomatic uterine adenomyosis is hysterectomy. Some studies discussed the possibility of uterine-sparing surgeries to treat adenomyosis, despite the controversy of application. Many patients prefer uterine-sparing lines of treatment over hysterectomy, especially after failure of medical treatment. Recent studies have been investigating uterine artery embolization (UAE) as a promising line of treatment of adenomyosis.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 35 Years 至 49 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Premenopausal women
- •Symptomatic pure adenomyosis or dominant adenomyosis when both adenomyosis and fibroids coexist
- •Women with an indication for hysterectomy (either failed or refused medical treatment).
排除标准
- •Patients under 18 years of age,
- •Patients with pelvic infection,
- •Suspected or confirmed malignancy
- •Current or future desire to conceive
- •Deep infiltrating endometriosis requiring surgery or obstructing the bowel, or
- •Coexisting hysteroscopically removable submucous fibroids
- •Any absolute contraindication to angiography such as:
- •hypersensitivity to intravenous contrast media,
- •impaired coagulation profile or
- •impaired renal function.
结局指标
主要结局
Management of symptomatic uterine adenomyosis
时间窗: three years
Relieving the symptoms of uterine adenomyosis using uterine artery embolization such as abnormal uterine bleeding and dysmenorrhea
次要结局
未报告次要终点
研究者
Sara Mohamed Gamal Hassan
Assistant Lecturer
Assiut University