Mitranovici Melinda-Ildiko, Costachescu Dan, Dumitrascu-Biris Dan, Moraru Liviu, Caravia Laura Georgiana, Bobirca Florin, Bernad Elena, Ivan Viviana, Apostol Adrian, Rotar Ioana Cristina, Marginean Lucian
Department of Obstetrics and Gynecology, Emergency County Hospital Hunedoara, 14 Victoriei Street, 331057 Hunedoara, Romania.
Department of Radiology and Medical Imaging, "Victor Babes" University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania.
J Clin Med. 2025 May 28;14(11):3788. doi: 10.3390/jcm14113788.
Adenomyosis is a benign gynecologic disease that mainly affects women aged 30-50 years old. : This pathology is characterized by glands and stroma of the endometrium that enter the myometrium and is confirmed through histopathological examination after hysterectomy. Transvaginal ultrasound is the most accepted imaging approach for the diagnosis and classification of adenomyosis. Existing medical treatments are not curative and are associated with several side effects. Uterine artery embolization is an alternative treatment for controlling the symptoms of adenomyosis with less trauma while preserving the uterus. : The aim of our study was to observe the utility of uterine artery embolization (UAE) compared to hysterectomy in specific cases of adenomyosis. A retrospective cohort study was carried out between February 2024 and April 2025. We included 52 patients in our study: 27 opted for hysterectomy, while the other 25 chose to receive uterine artery embolization between January 2017 and December 2018. Clinical follow-up was assessed using a questionnaire regarding symptomatic changes in menorrhagia, pelvic pain, and quality of life before and after the surgical procedure. Statistical analyses were performed. : Patients opted for hysterectomy in cases of severe abnormal uterine bleeding before surgery that severely affected quality of life ( < 0.03 and < 0.001). After surgery, pelvic pain improved for women who underwent UAE, but patients also reported no pelvic pain after hysterectomy. Furthermore, mild to moderate abnormal uterine bleeding was reported in cases of UAE, and bleeding stopped completely for women who had their uterus removed ( < 0.001). Quality of life improved for both groups and was reported as being good after the interventions. : Embolization remains an alternative therapeutic option in adenomyosis but not a substitute for hysterectomy. This was concluded based on a case-by-case evaluation, depending on the desire for pregnancy, with a focus on improved clinical outcomes.
子宫腺肌病是一种主要影响30至50岁女性的良性妇科疾病。这种病理特征是子宫内膜的腺体和间质侵入子宫肌层，并在子宫切除术后通过组织病理学检查得以确诊。经阴道超声是子宫腺肌病诊断和分类最常用的影像学方法。现有的药物治疗无法治愈该病，且伴有多种副作用。子宫动脉栓塞术是一种控制子宫腺肌病症状的替代治疗方法，创伤较小，同时保留子宫。我们研究的目的是观察子宫动脉栓塞术（UAE）与子宫切除术在特定子宫腺肌病病例中的效用。在2024年2月至2025年4月期间进行了一项回顾性队列研究。我们的研究纳入了52例患者：27例选择子宫切除术，另外25例在2017年1月至2018年12月期间选择接受子宫动脉栓塞术。通过一份关于手术前后月经过多、盆腔疼痛和生活质量症状变化的问卷对临床随访进行评估。进行了统计分析。手术前，严重异常子宫出血且严重影响生活质量的患者选择子宫切除术（<0.03和<0.001）。手术后，接受UAE的女性盆腔疼痛有所改善，但子宫切除术后的患者也报告无盆腔疼痛。此外，UAE病例报告有轻度至中度异常子宫出血，而子宫切除的女性出血完全停止（<0.001）。两组患者的生活质量均有所改善，干预后报告良好。栓塞术仍然是子宫腺肌病的一种替代治疗选择，但不是子宫切除术的替代方法。这是根据逐案评估得出的结论，取决于对妊娠的期望，重点是改善临床结果。
