Embolization for uterine fibroids treatment of uterine applied relatively recently, from the late 90s of the last century. This technique is most effective in the treatment of small submucous and intramural fibroids - uterine fibroids decrease in size and do not grow. At the same time restores woman's menstrual cycle and are in pain.
Embolization of uterine fibroids - what is it?
Correct this method is called uterine artery embolization (UAE). This method has been used for over 30 years to stop uterine bleeding
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Developing after childbirth and gynecological operations. For the treatment of uterine fibroids, NASA used it more than 20 years ago, and in Russia to this end, ESA officially applied since 1998.
EMA method is that by introducing into the uterine artery occlusion special particles are those of its branches that carry blood to the fibroids. This effect is possible because the blood supply is from leiomyomata their particular network environment vessels having a larger diameter than the vessels that carry blood to the surrounding healthy tissue tumor.
Following occlusion of these vessels gradual replacement by connective tissue uterine tissue while decreasing its volume. Formed connective tissue has no tendency to sprawl, on the contrary, during the following year significantly reduced the tumor. Small tumors are quite.
How is the procedure
Carrying EMA requires special skills, so vascular surgeon carried out under the control angiography (X-rays of the arteries) and under local anesthesia. The upper thigh make mini-puncture of the skin and are administered through the femoral artery of a special catheter. Under the control of X-ray TV installation catheter is advanced into the uterine artery and through it entered mikrochastichki substance plugging the lumen of blood vessels that feed tumors. The procedure is performed, first the right and then the left, and lasts an average of no more than half an hour.
A few days after the procedure, the women are pain and vaginal bleeding (both related and not related to the menstrual cycle). Gradually decreases and after a few weeks of fully taper off symptoms of compression fabrics - urinate is free and painless, are pain during bowel movements, symptoms of hemorrhoids, constipation, gradually improving digestion. All these symptoms usually disappear within six months after the UAE. Pronounced symptoms of compression of the tissues tested a year later, when the volume of large fibroids decreased an average of four times, and small knots disappear completely.
Recurrence of the disease after UAE, in most cases do not arise. Unfortunately, there is little experience in applying this method to the treatment of women of reproductive age. In particular, do not set the degree of risk of infertility after such treatment of fibroids, so in most cases experts are hesitant to use it to treat women who want to have children later.
Indications and contraindications for the procedure, uterine artery embolization
The procedure is indicated for embolization of uterine fibroids, which are accompanied by uterine bleeding and pain, symptoms of compression of the surrounding tissues, while asymptomatic fibroids, fibroids in women who for health reasons is contraindicated surgery, when a woman has contraindications for hormone replacement therapy
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. EMA is also carried out to reduce the size of fibroids prior to myomectomy and conservative in multiple uterine fibroids
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women who want to restore or preserve their reproductive function (if the alternative is removal of the uterus).
Contraindications for uterine artery embolization are: infectious and inflammatory processes in the uterus and pelvic organs, pregnancy, cancer, fibroids subserous on thin long leg (there is risk of falling necrotic node in the abdominal cavity). Submucosal fibroids on thin legs are a relative contraindication, as the more reliable is their removal using a hysteroscope.
Do not use if you are hypersensitive EMA radiopaque substance, impaired renal function, and increased tortuosity of blood vessels through which the catheter must penetrate into the uterine artery.
During the procedure, the EMA side effects usually do not happen. A few hours after the procedure, there are severe pain in the abdomen
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Associated with fibroid tissue death. Pain can last a few hours, but well removed pain medication. For the same reason, women may be somewhat understood the temperature, general weakness and malaise. All these phenomena take place throughout the day.
Sometimes (quite rarely) a woman for six months after the EMA appear menstrual disorders and even complete absence of menstruation (amenorrhea), but it goes with the times.