The Incidence and Risk Factors for the Presence of Type 1B or Type 3 Utero-ovarian Anastomoses During Uterine Artery Embolization

Year 2024, , 100 - 103, 29.02.2024

Ferdi Çay , Fatma Gonca Eldem , Barbaros Erhan Çil , Bora Peynircioğlu

https://doi.org/10.54005/geneltip.1367339

Abstract

Background/Aims: Demonstration of possible utero-ovarian anastomoses (UOA) before or during uterine artery embolization (UAE) is important to preserve ovarian reserve. This study aimed to evaluate the incidence and risk factors for the presence of type 1b or type 3 UOA in patients undergoing UAE for the treatment of uterine myomas.
Methods: Procedural angiographies of patients who underwent UAE were evaluated in a single academic center. Patients’ demographics, indication for UAE, presence and type of UOA, presence of adnexal pathology at preprocedural MRI, history of pelvic surgery, and total uterine volume at preprocedural MRI were retrospectively evaluated. Analysis of the aforementioned variables between patients with and without UOA was performed.
Results: This study included 30 patients with a mean age of 41.97±5.72 years (range 32 - 56). UOA was found in 17 (56.6%) patients, 10 (33.3%) of them were type 1b, and 7 (23.3%) of them were type 3. Five patients (17.2%) had adnexal pathology at pre-procedural MRI and 12 patients (40%) had a history of pelvic surgery. The mean total uterine volume was 607.1 cm3. In the analysis of variables between patients with and without UOA, UOA presence was significantly higher in patients with a history of pelvic surgery (p=0.005). All of the patients with a history of myomectomy were found to have type 1b or type 3 UOA. No significant relation between UOA and age, the presence of adnexal pathology, and uterine volume were detected.
Conclusion: Utero-ovarian anastomoses are commonly encountered during UAE. A history of pelvic surgery was found to be a risk factor for the presence of type 1b and type 3 UOA.

Keywords

Uterine artery embolization, utero-ovarian anastomoses, arterial angiography, pelvic surgery, ovarian reserve, risk factors, premature menopause

Uterin Arter Embolizasyonu Sırasında Tip 1B veya Tip 3 Utero-ovaryan Anastomoz Varlığının Sıklığı ve Risk Faktörleri

Abstract

Giriş/amaç: Uterin arter embolizasyonu (UAE) öncesinde veya sırasında olası utero-ovaryan anastomozların (UOA) gösterilmesi over rezervinin korunması açısından önemlidir. Bu çalışma, uterus miyomu tedavisi için UAE uygulanan hastalarda tip 1b veya tip 3 UOA varlığına ilişkin insidansı ve risk faktörlerini değerlendirmeyi amaçlamıştır.
Yöntem: UAE yapılan hastaların işlem anjiyografileri tek akademik merkezde değerlendirildi. Hastaların demografik özellikleri, UAE endikasyonu, UOA varlığı ve tipi, işlem öncesi MRG'de adneksiyal patoloji varlığı, pelvik cerrahi öyküsü ve işlem öncesi MRG' de toplam uterus hacmi retrospektif dosya incelemesi ile değerlendirildi. Yukarıda belirtilen değişkenlerin UOA’sı olan ve olmayan hastalar arasında analizi yapıldı.
Bulgular: Bu çalışmaya yaş ortalaması 41.97±5.72 yıl (32 – 56 yıl arası) olan 30 hasta dahil edildi. Hastaların 17'sinde (%56.6) UOA saptandı, bunların 10'u (%33.3) tip 1b, 7'si (%23.3) tip 3 idi. İşlem öncesi MRG'de 5 hastada (%17.2) adneksiyal patoloji vardı. On iki hastada (%40) pelvik cerrahi öyküsü vardı. Ortalama toplam uterus hacmi 607.1 cm3 idi. UOA olan ve olmayan hastalar arasındaki değişkenlerin analizinde, pelvik cerrahi öyküsü olan hastalarda UOA varlığı anlamlı derecede yüksekti (p=0.005). Miyomektomi öyküsü olan hastaların tamamında tip 1b veya tip 3 UOA mevcuttu. UOA ile yaş, adneksiyal patoloji varlığı ve uterus hacmi arasında anlamlı bir ilişki saptanmadı.
Sonuç: Utero-ovaryan anastomozlara UAE sırasında sıklıkla rastlanır. Bu çalışmada pelvik cerrahi öyküsü tip 1b ve tip 3 UOA varlığı için bir risk faktörü olarak bulunmuştur.

Keywords

Uterin arter embolizasyonu, utero-ovaryan anastomozlar, arteriyel anjiyografi, pelvik cerrahi, over rezervi, risk faktörleri, erken menopoz

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