Uterine artery embolisation for uterine fibroids: Our experience at a tertiary care service hospital

D’Souza, John; Kumar, Sushil; Hande, Pradipta C; Singh, S. N.

doi:10.1016/j.mjafi.2015.04.005

Cited by 5 publications

(4 citation statements)

References 20 publications

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“…Several therapeutic modalities, such as myomectomy (abdominal/vaginal/hysteroscopic), myolysis, endometrial ablation, uterine artery occlusion, uterine artery embolization, medical therapy with gonadotrophin-releasing hormone agonist, progestational compounds, etc., are uterine fibroid options that preserve the uterus. Focused high-frequency ultrasound therapy with MRI guidance has also been tried recently [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Alternatives to hysterectomy include the use of NSAIDs, oral contraceptive pills, levonorgestrel IUD, GnRH agonists, GnRH antagonists, and endometrial ablation. In the last few decades, in addition to medical treatment, several semi-invasive and uterus-preserving operations have been developed in the quest to reduce morbidity [ 4 ]. Uterine artery embolization (UAE), recommended for premenopausal women who failed hormonal control and want to keep the uterus, is a treatment option for uterine fibroids to reduce abnormal bleeding and pain/pressure symptoms [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Expulsion of Infarcted Myoma Following Ultrasound-Guided Uterine Artery Embolization: A Fertility-Preserving Approach

Goyal¹,

Agrawal²,

Eleti³

2022

Cureus

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The most frequent benign tumor of the female pelvis, uterine fibroids (leiomyomas), have a lifetime frequency of about 70% among Caucasian women. The most preferred treatment for fibroids is still hysterectomy, albeit there are issues with its misuse. Today, uterine artery embolization (UAE) is a wellrecognized minimally invasive treatment for symptomatic fibroids. A 29-year-old female came with heavy menstrual bleeding for two months. Ultrasonography revealed a large fibroid of 8cm x 7cm in the posterior wall of the myometrium. She underwent uterine artery embolization for the same. The fibroid was expelled through the vagina in small portions over one month following the intervention. There was a significant reduction in the fibroid size with a considerable amount of symptomatic relief to the patient within a month. The most prevalent benign pelvic tumor, uterine fibroids, affects over 40% of women of reproductive age. Uterine artery embolization is a safe and successful alternative to surgery for treating symptomatic fibroids, with significantly lower morbidity and mortality. It also preserves fertility, giving the patient hope for a future pregnancy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Expulsion of Infarcted Myoma Following Ultrasound-Guided Uterine Artery Embolization: A Fertility-Preserving Approach

Goyal¹,

Agrawal²,

Eleti³

2022

Cureus

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“…It is designed as such to treat conservatively for keeping uterus intact. 7 The most important aspect to keep in mind is to preserve fertility. This stage ought to be taken into account of the various different embolotherapy that are used such as pledgets of absorbable gelatin sponge or non-bovine sponge, and other therapies like definitive vascular occlusion, i.e.…”

Section: Introductionmentioning

confidence: 99%

Management of obstetric hemorrhage; an observational study highlighting the efficacy of uterine artery ligation

Ghouri

Mushtaq²,

Ahmed

et al. 2020

Int J Res Med Sci

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Background: Obstetrical hemorrhage is leading cause of maternal mortality. UAE is termed safe and effective method for resolving hemorrhage. objective of this study was to determine efficacy of uterine artery ligation in management of obstetrical hemorrhage.Methods: This cross sectional observational using non-probability convenient sampling technique was carried out for six months. After ethical approval, females between 18 to 35 years diagnosed with obstetrical hemorrhage, uterine atony refractory to medical treatment, having active bleeding from placental side or having normal coagulation profile were while females with post-partum hemorrhage because of retained products of conception, due to genital tract trauma or with disseminated intravascular coagulation were excluded. Analysis of data was done using SPSS version 23.0. Quantitative variables were reported as mean and standard deviation and for qualitative variables, frequency and percentages. Chi-square test was applied keeping p-value of <0.05 as statistically significant.Results: From 109 females with mean age 47±5.25 years. In comparison of parity distribution, 62 (56.88%) were multiparous and 47 (43.12%) were primiparous. Type of bleeding observed was antepartum 36(33.03%), peripartum 39 (35.78%) and postpartum in 34 (31.19%). Efficacy of uterine artery ligation in management of obstetric hemorrhage was observed to be 35 (32.11%). The efficacy of uterine artery ligation in management of obstetric hemorrhage in three categories of age groups reported significant association (p=0.0005) and type of bleeding (p=0.025).Conclusions: Efficacy of UAE in different types of obstetrical hemorrhage reported in our study was lower than expected in about one-third of females.

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“…Uterine fibroids are the most common benign lesions of the female reproductive system, that mostly occur in the 30–50-year-old female population ( 1 ), can cause menstrual changes (especially by excessive, shortening cycle), lower abdominal mass, infertility, increased leucorrhea, frequent urination, urgency, dysuria, constipation and other oppressive symptoms, and 4–8% ( 2 ) of uterine fibroids may be malignant, so it needs attention clinically and active and effective treatment. However, the etiology of uterine fibroids is not yet fully clear, although there are various drug treatment methods, the side effects are severe, and they can only temporarily alleviate the symptoms, shrink the tumor, the tumor begin to grow again after withdrawing the drug, symptoms recur, the methods are not easy and cannot be performed in a long-term ( 3 ). At present, surgical treatment has become the main treatment of uterine fibroids, in recent years, with the delay of female reproductive age, the incidence is increasing year by year and the occurrence is at younger age, and with the continuous development of minimally invasive technology, the laparoscopic minimally invasive surgery which only resect uterine myoma to retain fertility are widely accepted.…”

Section: Introductionmentioning

confidence: 99%

Analysis of the effect of laparoscopy and hysteroscopy on ovarian function, immune function and quality of sexual life of patients with hysteromyoma at different ages

Zhang

Meng

et al. 2017

Oncol Lett

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This study aims to comparatively analyze the impact of laparoscopic myomectomy (LM) and transcervical resection of myoma (TCRM) on ovarian function, immune function and quality of sexual life of patients with hysteromyoma. Two hundred and forty patients with hysteromyoma admitted into the Second Affiliated Hospital of Zhengzhou University from June 2014 to June 2016 were divided into laparoscopic myomectomy group (LM group, n=120) and transcervical resection of myoma group (TCRM group, n=120) according to random figure table. The difference between the two surgical methods were compared among hysteromyoma patients of different age in the following aspects: perioperative indicators, ovarian function, immune function and quality of sexual life before treatment and after operation. 1) there was no significant difference in age structure between LM and TCRM group (P>0.05). 2) There were no significant differences in the amount of bleeding, operative time, analgesics usage rate between the groups (P>0.05), but the anal exhaust time, postoperative ambulation time, hospitalization time and hospitalization costs in TCRM group were significantly less than that in LM group, the difference was statistically significant (P<0.01). 3) Before treatment and in the 3rd, and 6th month after operation, there was no significant difference on follicle stimulating hormone (FSH), luteinizing hormone (LH) or estradiol (E2) level between the two groups (P>0.05); but in the 3rd month after operation, the level of E2 decreased remarkably, with FSH and LH level increased significantly compared with the 6th month after operation and before treatment (P<0.05). 4) Compared with the preoperative status, there was no significant decrease in humoral immunity (IgG, IgA, IgM) and cellular immune function (CD4+, CD8+) in TCRM group at the 3rd and 6th month after operation (P>0.05). While at the 3rd month after operation, the levels of CD4+, CD8+ were decreased significantly in comparison to those at the 6th month after operation (P<0.05), but the levels of IgG, IgA and IgM were not decreased significantly (P>0.05). 5) There was no significant difference in the quality of sexual life between the two groups before operation or at the 3rd and 6th month after operation (P>0.05). In recent years, endoscopic treatment has become the main treatment evolution of hysteromyoma, patients of all ages are paying attention to the preservation of the uterus. This study showed that TCRM is approaching through the natural cavity, which has the features of less damage to body, faster recovery and lower cost of hospitalization than LM. The two surgical methods have no obvious influence on ovarian function, immune function and quality of sexual life.

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Uterine artery embolisation for uterine fibroids: Our experience at a tertiary care service hospital

Abstract: Uterine artery embolisation can be considered as an alternative to hysterectomy in appropriately selected symptomatic patients of uterine fibroids.

Cited by 5 publications

References 20 publications

Expulsion of Infarcted Myoma Following Ultrasound-Guided Uterine Artery Embolization: A Fertility-Preserving Approach

Expulsion of Infarcted Myoma Following Ultrasound-Guided Uterine Artery Embolization: A Fertility-Preserving Approach

Management of obstetric hemorrhage; an observational study highlighting the efficacy of uterine artery ligation

Analysis of the effect of laparoscopy and hysteroscopy on ovarian function, immune function and quality of sexual life of patients with hysteromyoma at different ages

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