Uterine Artery Embolization Using Gelatin Sponge Particles in Patients with Symptomatic Uterine Fibroids: A Systematic Review and Meta-Analysis.

In 30 seconds

This systematic review and meta-analysis assessed the efficacy and safety of uterine artery embolization (UAE) using gelatin sponge particles in patients with symptomatic uterine leiomyomas. It included six prospective or retrospective nonrandomized studies with 429 participants; three studies compared gelatin sponge with another embolic agent. Pooled mean dominant leiomyoma volume reduction was 42.17% at 3 months, 53.37% at 6 months, and 58.71% at 12 months. Menorrhagia, dysmenorrhea, and bulk-related symptoms also commonly improved. Amenorrhea was the most frequently reported adverse event.

Key findings

• 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% at 3 months, 95% at 6 months, and 98% at 12 months.
• Bulk-related symptoms improved in 90% at 3 months and 99% at both 6 and 12 months.
• Amenorrhea was the most common adverse event; other reported events included deep venous thrombosis, fibroid passage, and postembolization syndrome.

Why it matters

The pooled findings suggest that UAE with gelatin sponge particles can be associated with reductions in leiomyoma volume and improvement in common fibroid-related symptoms over follow-up. The review also identifies adverse events relevant to counselling and monitoring. Because the evidence comes from nonrandomized studies, these results describe outcomes with this approach but do not establish its comparative effectiveness against other embolic agents or treatments.

What to keep in mind

The review included only six nonrandomized studies, and only three compared gelatin sponge with another embolic agent; the evidence therefore has limited capacity to establish comparative effects.