137 - Long-Term Outcomes of Uterine Artery Embolization for Treatment of Fibroids in Younger Patients

Monday, March 31, 2025

12:10 PM – 1:10 PM CT

Location: Music City Center, Expo Poster Area

Poster Presenter(s)

Elisabeth R. Seyferth, MD

IR Resident
University of Pennsylvania Health System, United States

Author/Co-author(s)

NH

Neil Harrison, MD

Assistant Professor
University of Pennsylvania Health System, United States
RS

Richard D. Shlansky-Goldberg, MD, FSIR

Professor
Perelman School of Medicine/ Univ. of Pennsylvania, United States

Purpose: To assess long-term outcomes and success of entering menopause without additional treatment for patients younger than 39 years old undergoing fibroid embolization (FE).

Materials and Methods: 976 total patients who underwent FE between 2001 and 2012 were identified from a quality assurance database at two institutions, of whom 111 were women younger than 39 at the time of FE. 54 of these women were reached over the phone and participated in a phone survey. 20 had a disconnected phone or wrong number, 33 did not answer, and 4 refused to participate. Self-reported patient characteristics and clinical outcomes were correlated with the medical record. The mean age at time of embolization was 35.1 (range 26.4-38.9), and the mean age at time of survey was 51.4 (range 43.1-61.4). 40.7% of patients reported bleeding symptoms before FE, 7.4% bulk symptoms, and 51.9% both bleeding and bulk symptoms. A sub-analysis was performed comparing outcomes between patients under 36 and those aged 36 to 38 at the time of FE.

Results: 68.5% (37 of 54) and 22.2% (12 of 54) of patients reported that their symptoms improved “a lot” or “a little,” respectively, in the first 6 months after FE, while 9.3% (5 of 54) reported no change. Of those with initial improvement, symptoms returned in 65.3% with a mean estimated time to return of 5.1 years (range 0.25-20 years). Symptoms were more likely to return in patients under 36 at the time of FE versus those 36-38 (80.0% vs 50.0%, p=0.03), although there was no difference in mean time to symptom return between the age groups. 32 patients underwent additional procedures for recurrent or persistent symptoms: 2 underwent repeat FE, 6 myomectomy, 2 endometrial ablation, 5 intrauterine device placement, and 21 hysterectomy. Patients under 36 were more likely to undergo hysterectomy than those aged 36-38 (53.6% vs 23.1%, p=0.02). The mean estimated time from FE to hysterectomy was 6.9 years. Among the 33 patients who did not have a hysterectomy, 8 are currently premenopausal, 18 are perimenopausal, and 7 are postmenopausal. Patients rated their satisfaction with having FE a mean of 3.9 on a scale of 1 to 5, with 5 being very satisfied. There was no difference in satisfaction between age groups.

Conclusion: Women under the age of 39 who undergo FE for symptomatic fibroids are likely to experience return of their symptoms before menopause and may require additional procedures. However, patient satisfaction with embolization remains high. Younger patients, particularly those under 36, should be counseled accordingly on the risk of recurrent symptoms due to the length of time to menopause.