Uterine Artery Embolization Using Gelatin Sponge Particles in Patients with Symptomatic Uterine Fibroids: A Systematic Review and Meta-Analysis
摘要
To assess the efficacy and safety of uterine artery embolization (UAE) using gelatin sponge (GS) particles through a systematic review and meta-analysis.
Materials and methodsPubMed, Embase, Scopus, and Google Scholar were searched from inception to April 2024. Prospective and retrospective nonrandomized studies using GS particles for UAE in leiomyoma patients were included. Outcomes included dominant leiomyoma volume reduction and improvement in menorrhagia, dysmenorrhea, and bulk-related symptoms.
ResultsSix studies with 429 participants were included. Three out of six studies compared GS to another embolic agent. Mean dominant leiomyoma volume reduction was 42.17% at 3 months (95% CI 33.65–50.68%), 53.37% at 6 months (95% CI 47.89–58.86%), and 58.71% at 12 months (95% CI 47.38–70.04%). Menorrhagia improved in 88% (95% CI 85–91%) at 3 months, 95% at 6 months (95% CI 70–100%), and 98% at 12 months (95% CI 92–100%). Dysmenorrhea improved in 90% at 3 months (95% CI 53–100%), 96% at 6 months (95% CI 66–100%), and 89% at 12 months (95% CI 61–100%). Bulk-related symptoms improved in 90% at 3 months (95% CI 74–99%) and 99% at 6 (95% CI 92–100%) and at 12 months (95% CI 95–100%). Amenorrhea was the most common adverse event. Other adverse events included deep venous thrombosis, groin hematomas, fibroid passage, symptom recurrence, anemia, postembolization syndrome, and elevated liver enzymes.
ConclusionUAE using GS particles is a potentially effective treatment option for managing uterine leiomyoma. It reduces leiomyoma volume and improves menorrhagia, dysmenorrhea, and bulk-related symptoms.
Level of EvidenceLevel 2a, Systematic Review & Meta-Analysis of Cohort Studies.
Graphical Abstract