Purpose: To determine (i) if preexisting hydrosalpinx poses a risk for development of pyosalpinx following uterine artery embolization (UAE) and (ii) the effect of UAE on fallopian tube diameter.
Materials and methods: Between 2005 and 2011, 429 women underwent UAE for treatment of symptomatic leiomyomas. Magnetic resonance (MR) imaging before UAE revealed 16 (3.7%) premenopausal women (median age, 47 y; range, 40-52 y) with preexisting hydrosalpinx. Bilateral UAE was performed by using 500-700-μm tris-acryl microspheres with the administration of routine prophylactic antibiotics. Pre- and post-UAE MR images were used to measure fallopian tube diameter. Fallopian tube diameters were classified as normal (1-4 mm) or mildly (< 10 mm), moderately (10-20 mm), or severely enlarged (> 20 mm). A diameter change ≥ 3 mm was considered significant. Resolution of hydrosalpinx was defined by the inability to identify fallopian tubes on post-UAE MR imaging or a normal fallopian tube diameter. Radiology and hospital records were reviewed to determine clinical outcomes.
Results: All 16 patients underwent successful bilateral UAE. Clinical follow-up ranged from 14 to 1,531 days (median, 106 d). There was no clinical evidence of pyosalpinx after UAE. Two patients experienced minor complications unrelated to fallopian tube dilation. Post-UAE MR images were available in 13 of 16 patients (81.3%). There were no MR findings to suggest pyosalpinx after UAE. Resolution or improvement was noted in four of 15 hydrosalpinges (26.7%) for patients with follow-up imaging.
Conclusions: The results of the present study suggest that UAE is safe for patients with preexisting hydrosalpinx.
Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.