Unique Learning System for Uterine Artery Embolization for Symptomatic Myoma and Adenomyosis for Obstetrician-Gynecologists in Cooperation with Interventional Radiologists: Evaluation of UAE From the Point of View of Gynecologists Who Perform UAE

Soeda, Shu; Hiraiwa, Tomoko; Takata, Megumi; Kamo, Norihito; Sekino, Hirofumi; Nomura, Shosaku; Kojima, Masayasu; Kyozuka, Hyo; Ozeki, Takeharu; Ishii, Shiro; Tameda, Tadanobu; Asano, Kimisato; Miyazaki, Makoto; Takahashi, Toshifumi; Watanabe, Takafumi; Taki, Yasunori; Fujimori, Keiya

doi:10.1016/j.jmig.2017.08.008

Cited by 10 publications

(6 citation statements)

References 27 publications

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“…CM, observation only, with or without gauze packing in the vaginal wall; SURG, requiring a wide incision over the hematoma or reopening the episiotomy repair, followed by removal of the blood clot and subsequent irrigation (without a drainage tube if possible); and AEM, arterial embolization of the bleeding artery via an interventional procedure. In our department, AEM is performed by an obstetrician/gynecologist and an interventional radiologist (IVR), working interchangeably as the first and second operators, sometimes with the support of additional gynecologists or IVRs (Soeda et al 2018). In brief, unilateral access to the femoral artery was achieved in most cases by the obstetrician/gynecologist under the guidance of the IVR.…”

Section: Methodsmentioning

confidence: 99%

“…In brief, unilateral access to the femoral artery was achieved in most cases by the obstetrician/gynecologist under the guidance of the IVR. The obstetrician/ gynecologist or IVR first performed super-selective catheterization of the bleeding artery using the coaxial technique with a 5-Fr Mohri catheter (Terumo Clinical Supply, Gifu, Japan) and a 2.4-Fr microcatheter (Renegade Hi-Flo; Boston Scientific, Tokyo, Japan), followed by embolization with gelatin sponge pieces (Spongel; Astellas, Tokyo, Japan, or Serescue; Nippon Kayaku, Tokyo, Japan) (Soeda et al 2018). On the basis of the significant findings of this study, we developed a potential management algorithm for PGHA.…”

Section: Methodsmentioning

confidence: 99%

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Establishing a Treatment Algorithm for Puerperal Genital Hematoma Based on the Clinical Findings

Soeda

Kyozuka

Kato

et al. 2019

Tohoku J. Exp. Med.

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Postpartum hemorrhage within 24 hours after delivery remains the leading cause of maternal mortality worldwide. Puerperal genital hematoma (PGHA) is a rare complication of postpartum hemorrhage, and PGHA can be life-threatening if hemostasis is not properly achieved. However, a reliable management algorithm for PGHA based on the clinical findings has not been developed. The objectives were to evaluate the management strategies for PGHA and identify the clinical findings that help select the treatment for PGHA. The medical records of women who were treated for PGHA in our department were reviewed, and data regarding the clinical findings and the treatment strategy for PGHA were analyzed. Thirty-four women who underwent treatment for PGHA were identified and divided into three groups according to the final procedure that achieved hemostasis: conservative management (CM) (n = 9), surgical management (SURG) (n = 15), and arterial embolization management (AEM) (n = 10). Regarding the clinical findings on initial evaluation, the shock index was significantly higher in the AEM group than in the CM or SURG group; and initial platelet count and fibrinogen level were significantly lower in the AEM group than in the CM group. There was no significant difference in any computed tomography (CT) finding among the three groups. In conclusion, this study clearly shows the difference in clinical findings among treatment strategies for PGHA. We suggest that the clinical findings of shock index, platelet count, and fibrinogen level together with CT findings are helpful and valuable for selecting the treatment strategy for PGHA.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Establishing a Treatment Algorithm for Puerperal Genital Hematoma Based on the Clinical Findings

Soeda

Kyozuka

Kato

et al. 2019

Tohoku J. Exp. Med.

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“…In Table 1 are summarized the complications in our participants and according to international literature with the maximally respectively referred complications rate. The first column of the table refers to our results in the time from 2008 to 2020 while in the second column are shown the respective values of the examinated parameters in average concerning to international literature [72][73][74][75][76].…”

Section: Postprocedureal Managementmentioning

confidence: 99%

The Contribution of Uterine Artery Embolization as a Safe Treatment Option for Uterine Fibroids

Tsikouras¹,

Bothou²,

Anthoulaki³

et al. 2021

Fibroids

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Uterine fibroids have remarkably heterogeneous clinical characteristics with unknown exact etiology. The treatment of fibroids should be individualized based on their size, location, growth rate, the symptoms that they cause, the desire to have children and the age of the woman. Embolization is currently the most advanced non-surgical technique. The majority of women report satisfactory post-treatment results like shorter hospitalization period and recovery time in comparison to hysterectomy and improvement or complete remission of clinical symptoms. Complications include amenorrhea (in the majority of cases: recurrence after three months) and infections that are generally treated with antibiotics. The results from most clinical studies and our published experience indicate that embolization improves pelvic symptoms related to uterine fibroids. Collaborative efforts between gynecologists and interventional radiologists are necessary in order to optimize the safety and efficacy of this procedure. In the future, embolization could be generally recommended as treatment option for women who desire future fertility/pregnancy.

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“…Conservative therapy options, such as myomectomy, can be considered in patients planning to conceive in the future. Hysterectomy and myomectomy, on the other hand, are linked to a longer hospital stay, a higher risk of blood loss, a longer operating time, and postoperative problems, all of which are concerning [4,5]. Surgical treatment of cervical fibroids necessitates a high level of surgical expertise.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous Expulsion of a Huge Cervical Fibroid After Uterine Artery Embolization Done as a Lifesaving Procedure for Acute Severe Abnormal Uterine Bleeding

Memon¹,

Acharya²,

Potdar³

2022

Cureus

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Uterine fibroids are a prevalent disease that most commonly affects women of reproductive age group and causes symptoms such as abnormal uterine bleeding that can have a detrimental impact on their quality of life. Being in the reproductive age group, fertility-conserving modalities in the form of hormonal therapy, myomectomy, hysterectomy, and uterine artery embolization (UAE) remain the main treatment options. Uterine artery embolization is one of the treatment options for select cases of fibroid uterus. Here, we present the case of a 36-year-old woman diagnosed with cervical leiomyoma who presented with uncontrollable uterine bleeding, severe anemia, and many failed medical therapies. Although the case did not fit within the usual UAE guidelines, the treatment was done to tide over the crisis as a temporary method to control severe hemorrhage. Bleeding was controlled immediately and the patient was getting prepared for major surgery with the correction of severe anemia. However, seven days after UAE, the fibroid spontaneously expelled itself, resulting in improved symptoms and the avoidance of surgery. The patient is currently symptomless and has improved sexual life, self-esteem, and quality of life.

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Unique Learning System for Uterine Artery Embolization for Symptomatic Myoma and Adenomyosis for Obstetrician-Gynecologists in Cooperation with Interventional Radiologists: Evaluation of UAE From the Point of View of Gynecologists Who Perform UAE

Cited by 10 publications

References 27 publications

Establishing a Treatment Algorithm for Puerperal Genital Hematoma Based on the Clinical Findings

Establishing a Treatment Algorithm for Puerperal Genital Hematoma Based on the Clinical Findings

The Contribution of Uterine Artery Embolization as a Safe Treatment Option for Uterine Fibroids

Spontaneous Expulsion of a Huge Cervical Fibroid After Uterine Artery Embolization Done as a Lifesaving Procedure for Acute Severe Abnormal Uterine Bleeding

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