What are Uterine Fibroids?
Some patients are misdiagnosed as having fibroids when in fact they have a condition called adenomyosis in which it is thought cells from the lining of the womb migrate into the muscle of the womb causing heavy painful periods. This is a benign condition which is best diagnosed using MRI. The condition, although not as common as fibroids, is still nevertheless a frequent cause of heavy, painful menstruation.
Adenomyosis which may coexist with fibroids is a condition in which cells from the lining of the womb (which sheds and bleeds during a period) are present on the muscle of the womb. It causes enlargement of the uterus, heavy periods and pain and tends to be progressive. It may affect fertility and it may also coexist with a condition called endometriosis where these womb lining cells are present in the peritoneal cavity. Adenomyosis usually presents over 35 years of age.
The traditional treatment for adenomyosis is hysterectomy. Endometrial ablation or Merina coil insertion may help in mild cases. Embolisation is being increasingly used to treat this condition.
Embolisation is not as effective as when used for treating fibroids. However one embolisation will usually cure the condition in 50% of cases. In the rest symptoms often return and these patients may require further embolisation treatment. Embolisation may also be combined with endometrial ablation or Mirena coil insertion.
Uterine Artery Embolisation for Symptomatic Adenomyosis - Midterm Results - Bratby MJ, Walker WJ - European Journal of Radiology - February 2008.
Midterm Results of UAE for Symptomatic Adenomyosis: Initial Experience - Pelage JP, Jacob D, Fazel A, Namur J, Laurent A, Rymer R, Le Dref O. - Radiology, March 2005; 234(3):948-953. Epub 2005 Jan 28.
Long Term Results of UAE for Symptomatic Adenomyosis - Kim MD, Kim S, Kim NK, Lee MH, Ahn EH, Kim HJ, Cho JH, Cha SH - Am J Roentgeonol 2007;188(1):176-181.