Can pain level after uterine artery embolization for uterine leiomyoma predict the effect of this procedure?

Introduction: Uterine leiomyoma is one of the most frequent gynecological benign conditions. Uterine artery embolization is a minimally invasive angiographic procedure that induces ischemia, fibrosis and slow resorption of uterine leiomyoma. The acute ischemia causes pain in the first 8 hours after the selective embolization of the uterine arteries. In some cases, due to variant anastomoses between the uterine and ovarian arteries this procedure is inefficient. This study was undertaken in order to determine if pain level after uterine artery embolization for uterine leiomyoma can predict the effect of this procedure. Material and methods: We evaluated 50 patients who underwent uterine artery embolization for uterine leiomyoma. All participants recorded the level of pain in the first 8 hours after the procedure using a 10 point visual analog scale with the value of 10 meaning "worst imaginable pain" and 1 "absence of pain". In group A (n=25) we enrolled patients who claimed levels of pain between 1 and 4 on the visual analog scale, while the rest formed group B (n=25). All patients were reevaluated after 3 respectively 6 months after the procedure in order to determine the effect of uterine artery embolization on the uterine leiomyoma. Results: Uterine artery embolization has been effective (reduced tumor size and decreased blood supply) in 4 patients enrolled in group A and 22 pertaining to group B. Conclusions: Pain level after uterine artery embolization for uterine leiomyoma can predict the effect of this procedure. The absence or low levels of pain correlate with a poor response of this technique.