Uterine artery embolization

In modern obstetrics and gynecology for more than 20 years as a stop postoperative and postpartum hemorrhage is used uterine artery embolization.

At present, this procedure is widely used in treatment of uterine fibroidsIt avoids the conservative treatment. This procedure consists of occlusion (occlusion) of blood vessels by means of a puncture of the femoral artery. Since the operation is almost painless for its implementation administered local anesthesia. For many years, women diagnosed with uterine fibroids resection appointed, until the complete removal of the uterus. The most common indication for surgery was the assumption the high proportion of the likelihood of degeneration of fibroids in malignancy. Amputation of the uterus, which is very poorly tolerated in women and usually leads to severe depression is the most common way of gynecological hysterectomy (surgery) to this day.

Description

gynecology, gynecological diseases, women, the uterus, uterine artery embolization

The new method was a real salvation for womenfrom complex surgery, due to the possibility of blocking the blood flow, supplying blood to fibromatous nodes. As a result of this procedure, myoma very quickly decreases in size. Embolization of the uterine arteries consists of introducing emboli into the uterine artery by means of a small puncture in the inguinal fold. An endovascular surgeon using X-ray equipment carefully monitors the movement of the catheter inside the artery and sequentially brings it to the uterine artery, stopping at the point where it branches. Thus, the treatment process consists in the puncture of the femoral artery, further catheterization of the uterine vessels and the subsequent administration of an embolization preparation, which gets stuck in the vessels and blocks them. The procedure is considered completed after the complete blockage of the blood vessels responsible for the blood supply to the fibroids. To achieve a guaranteed result, uterine artery embolization is performed on both sides. As a confirmation of the cessation of blood supply to the nodes, a control arteriogram is performed. The puncture sites are carefully treated with an antiseptic solution and squeezed with a sterile dressing for 12 hours.

Assignment method

Clinical classification of uterine fibroids determines the treatment of patients:

  • with small (1-2 cm) fibroids prescribe combined oral contraceptives (combined hormonal) or intrauterine releasing system;
  • in the presence of fibroids is medium in size (3-4 cm) is assigned a two-stage treatment;
  • detection of large fibroids (over 4.5 centimeters) appoint conservative myomectomy (removal of fibroids) or uterine artery embolization;
  • myoma on a stalk require laparoscopic (through a small hole) removal;
  • submucous (submucosal) fibroids, up to 3 centimeters require hysteroresectoscopy (intrauterine surgery).

By holding uterine artery embolization, there are certain indications and contraindications. Embolization of the uterine arteries in the following cases:

  1. When the diagnosis is established, or growing symptomatic uterine fibroids
  2. appointment procedure is recommended:

    • in establishing the size of the uterus, the relevant pregnancies from 7 to 20 weeksbut only if notpathology of the endometrium, ovaries and cervix. Embolization with a smaller uterus is undesirable because the success of its implementation is very small;
    • when women are interested in the preservation of reproductive function, along with the established influence of fibroids in the pathogenesis of infertility or assumption high probability of miscarriage;
    • during the preparations for the miomektamii (removal of fibroids) or hysteroresectoscopy (intrauterine surgery).
    • with significant uterine bleeding of various etiologies, in cases where all other methods of treatment of life-threatening patient.
  3. Embolization may be contraindicatedin case of detection of infection or the presence of severe allergies to medications used, leading to angioedema or anaphylactic shock.

The advantages of the procedure

gynecology, gynecological diseases, women, the uterus, uterine artery embolization

Uterine artery embolization has several advantages compared with other treatments. following positive moments can be attributed to them:

  1. Being able to avoid surgery and to guarantee the preservation of the uterus.
  2. Continuation of the reproductive capacity of women.
  3. Avoiding the use of general anesthesia and rapid recovery after an eight-hour bed rest.
  4. The absence of large scars and skin lesions. Traces of two punctures very quickly disappear.
  5. In case of increase of temperature or pain that is extremely rare, quite a short course of anti-inflammatory drugs and analgesics.

Numerous reviews of grateful womenunanimously testify that the procedure is completely painless and is extended to 10 minutes. Along with full functions of the uterus, completely stops the progression of the tumor, and it happens fast enough reduction in size.

At the end of the article, it should be added that inat the moment, uterine mimoma has become much more often diagnosed in young girls who not only did not have time to learn the joys of motherhood, but also enter a full-fledged adult life. In a modern clinic, embolization of the uterine arteries is still quite an expensive procedure. However, it should be recognized that this method is really worth it. The total amount of the procedure includes the price of the embolizing drug, the tools and materials used, the work of the doctor, as well as the hospital stay.

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