Resolution of hydronephrosis after uterine artery embolization for fibroids

Daniel Alyeshmerni, Filip Banovac, Marieta Pehlivanova, Michael McCullough, Barry Hansford, James Spies

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: To determine the prevalence, predisposing factors, and resolution of hydronephrosis among patients undergoing uterine artery embolization (UAE) for fibroids. Materials and Methods: From October 2004 to May 2008, 1,114 patients underwent UAE at an academic medical center. Hydronephrosis was found on angiographic images in 101 patients. In 34 of these patients, 3-month ultrasound follow-up was available. The angiographic images were graded for hydronephrosis severity by three interventional radiologist reviewers. The degree of residual hydronephrosis was obtained from ultrasound images or reports in 3-month follow-up imaging. Descriptive statistics summarizing outcomes and interobserver agreement regarding hydronephrosis grade were calculated. In a parallel assessment, prospectively gathered baseline data available from 776 patients undergoing UAE were analyzed to identify predisposing factors to hydronephrosis. Results: Among the 34 patients with hydronephrosis and appropriate follow-up, resolution occurred in 28 of 34 (82%) patients. Among the entire study group, 9.0% (101 of 1,114) of patients had unilateral or bilateral hydronephrosis. Hydronephrosis was less frequent in left kidneys (4.5% [35 of 776]) than right kidneys (6.3% [49 of 776]; P = .013). The mean uterine volume in the group with hydronephrosis was greater than in the group without hydronephrosis (1,041 cm 3 vs 609 cm 3; P < .0001), and the mean dominant fibroid volume was also greater (233 cm 3 vs 147 cm 3; P < .0001). Conclusions: These results suggest that UAE may result in resolution of hydronephrosis in a notable number of cases. Large uterine size and dominant fibroid size was associated with hydronephrosis.

Original languageEnglish (US)
Pages (from-to)865-869
Number of pages5
JournalJournal of Vascular and Interventional Radiology
Volume22
Issue number6
DOIs
StatePublished - Jun 1 2011
Externally publishedYes

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Uterine Artery Embolization
Hydronephrosis
Leiomyoma
Causality
Kidney

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Resolution of hydronephrosis after uterine artery embolization for fibroids. / Alyeshmerni, Daniel; Banovac, Filip; Pehlivanova, Marieta; McCullough, Michael; Hansford, Barry; Spies, James.

In: Journal of Vascular and Interventional Radiology, Vol. 22, No. 6, 01.06.2011, p. 865-869.

Research output: Contribution to journalArticle

Alyeshmerni, Daniel ; Banovac, Filip ; Pehlivanova, Marieta ; McCullough, Michael ; Hansford, Barry ; Spies, James. / Resolution of hydronephrosis after uterine artery embolization for fibroids. In: Journal of Vascular and Interventional Radiology. 2011 ; Vol. 22, No. 6. pp. 865-869.
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abstract = "Purpose: To determine the prevalence, predisposing factors, and resolution of hydronephrosis among patients undergoing uterine artery embolization (UAE) for fibroids. Materials and Methods: From October 2004 to May 2008, 1,114 patients underwent UAE at an academic medical center. Hydronephrosis was found on angiographic images in 101 patients. In 34 of these patients, 3-month ultrasound follow-up was available. The angiographic images were graded for hydronephrosis severity by three interventional radiologist reviewers. The degree of residual hydronephrosis was obtained from ultrasound images or reports in 3-month follow-up imaging. Descriptive statistics summarizing outcomes and interobserver agreement regarding hydronephrosis grade were calculated. In a parallel assessment, prospectively gathered baseline data available from 776 patients undergoing UAE were analyzed to identify predisposing factors to hydronephrosis. Results: Among the 34 patients with hydronephrosis and appropriate follow-up, resolution occurred in 28 of 34 (82{\%}) patients. Among the entire study group, 9.0{\%} (101 of 1,114) of patients had unilateral or bilateral hydronephrosis. Hydronephrosis was less frequent in left kidneys (4.5{\%} [35 of 776]) than right kidneys (6.3{\%} [49 of 776]; P = .013). The mean uterine volume in the group with hydronephrosis was greater than in the group without hydronephrosis (1,041 cm 3 vs 609 cm 3; P < .0001), and the mean dominant fibroid volume was also greater (233 cm 3 vs 147 cm 3; P < .0001). Conclusions: These results suggest that UAE may result in resolution of hydronephrosis in a notable number of cases. Large uterine size and dominant fibroid size was associated with hydronephrosis.",
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