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Uterine Mioma Embolization

This treatment, also known as uterine artery embolization, is indicated for women with symptoms caused by uterine myomas, also called fibroids (benign tumors of the uterus). Although benign, these tumors can produce symptoms such as excessive vaginal bleeding, especially during menstruation (menstrual overflow) or for prolonged periods (metrorrhagia), pain or feeling of pressure in the womb, and increased urinary frequency. There are some women who may present pain during sexual intercourse due to myoma growth.

 

The treatment known as embolization (obstruction of the myoma blood supply) is performed using X-rays (fluoroscopy) and epidural or spinal anesthesia. The procedure is minimally invasive and is done by inserting a thin catheter (2 mm diameter) into the patient's groin. Typically, there are two vessels (arteries) that carry the blood into the uterus where the fibroids are. These arteries that feed the myomas with blood are artificially clogged using microspheres (like grains of sand) harmless to the body. These spheres are injected directly into fibroids until their complete devascularization. The goal is to have a "benign infarction" of fibroids so that they decrease in size and symptoms are controlled.

 

This is a worldwide renowned treatment and was developed 20 years ago, demonstrating to be safe, effective, long lasting and much less invasive than traditional surgery. It is performed by Interventional Radiologists who have had adequate training, as an option to uterus and/or fibroids excision.

 

Fibroids occur in 20 to 25% of women of childbearing age, and 10 to 20% have symptoms. Women born in continents such as Africa and America have 50% more chance of having this disease. In the United States, out of the 600,000 uterus removals annually by traditional surgery, 30% is due to myoma. After embolization, patient discharge usually occurs within the first 24-48 hours, allowing return to work activities in 7 to 10 days.

 

The results demonstrate that it is possible to treat most women with fibroids through embolization. However, all patients require consultation and follow-up with a gynecologist before and after treatment. Laboratory and imaging tests such as ultrasonography and magnetic resonance imaging are necessary for proper case analysis. Surveys show that treatment satisfaction rate is high, varying from 88 to 94%.

 

The treatment is very effective for this type of disease, with no major restrictions related to size or number of tumors. One or more fibroids can be treated at the same time with only one embolization. Tumor size reduction can reach up to 70% in the follow-up period, but the improvement of symptoms can occur regardless of a significant diminution. The median reduction in fibroids’ size and uterine volume varies by about 40-60%.

 

Source: http://www.sirweb.org/medicalprofessionals/GR_PDFs/UFE_Grand_Rounds.pdf

 

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