Is embolization effective in adenomyosis? ​ ​

Embolization is also a very effective treatment method in adenomyosis patients. It was discovered by chance that this method could treat adenomyosis as well as fibroids. In a study published for the first time in 2001, it was determined that in 9 patients with fibroids + adenomyosis, the fibroids died after embolization, but at the same time, the adenomyosis areas were reduced and the complaints such as bleeding and severe pain caused by adenomyosis disappeared. Later, embolization was also performed in patients with only adenomyosis, and it was observed that the areas of adenomyosis and the size of the uterus were reduced, and the complaints of adenomyosis were reduced or completely disappeared. ​

 

​Since then, embolization has been increasingly used in patients with adenomyosis. In studies conducted with thousands of patients, it was observed that adenomyosis complaints decreased or disappeared in 80-90% of patients after embolization and  this situation continued in the long term for at least 5 years. ​ ​

 

Embolization procedure:

Adenomyosis embolization is the same as embolization for fibroids. It is done under local anesthesia and conscious sedation. After the artery of the groin is catheterized, the catheter is advanced into both uterine arteries and occluding particles are injected. After this procedure, which takes about an hour, control shots are taken and the catheter in the groin is taken out. To prevent bleeding, the inguinal artery is manually pressed for 15 minutes and a bandage is applied.

 

After the embolization, the adenomyosis areas are not dead (unlike fibroids) but they become smaller and the symptoms such as bleeding and pain either improve or disappear. 

​

​

​

​

​

​

​

​

​

​

​

​

​

The fact that embolization is effective in both myoma and adenomyosis is an important advantage, because these two diseases can be confused with each other and can be found together in many patients. Especially focal adenomyosis, can be confused with fibroids on ultrasound and even on MRI.  It is usually possible to distinguish between these two diseases on the MRI images after embolization; fibroids both shrink and turn black (become dead) after embolization. Focal adenomyosis areas do not turn black, they just shrink. However, the patient's complaints of adenomyosis disappear. ​ ​

 

Video: Embolization in the treatment of adenomyosis, Prof Dr Saim Yılmaz