Embolization of uterine arteries with uterine myoma: treatment and consequences

One of the branches of medicine is reproductive. It is one of the most delicate, because it is directly related to the most important purpose of every woman - to become a mother.

The methods that are practiced in this industry are also aimed at preparing the body for the main event in the life of a woman. It should be noted that in modern times quite a large number of women suffer from various inflammatory and infectious diseases of the reproductive system, which often causes infertility or the inability to tolerate the baby.

Most often among all pathologies met uterine fibroids. It can lead to infertility, with each year the medicine moves further and completely new methods of therapy appear that can bring women closer to their cherished goal.

One of these modern methods is embolization of uterine arteries in uterine myomas. With this method of getting rid of fibroid, we'll get acquainted in our article.

What is myoma of the uterus?

This pathology includes benign neoplasm in the muscular layer of the uterus. At the very beginning of its development it looks like a small nodule of irregular shape.

It is quite easy to recognize the disease on an ultrasound examination, but before a doctor visits a woman can feel the pain in the lower abdomen, a violation of the process of urination. Many have uterine bleeding, which some try to give out for the menstrual cycle.

Most often suffer from this pathology of a woman of reproductive age, if delayed with treatment, then close to infertility and other complications.

The essence of the method

Embolization of the uterine arteries in uterine myomas is a new method of therapy of this disease, which allows you to get rid of tumors without resorting to surgical intervention. Complications after such an intervention are rare, so the method is considered the most sparing and quite effective.

If uterine artery embolization is prescribed for uterine myoma, the essence of the treatment is reduced to the introduction of plasticizer balls into the arteries feeding the neoplasm. They will block the blood flow, and the fibroids gradually die.

When an embolization is prescribed

Many women have a question: "If there is a neoplasm, then embolization of uterine arteries with uterine myoma when appointed?" Are there any contraindications to this procedure? First, we will analyze the testimony, and these are:

• Myoma is growing.
• There is no possibility to perform surgical treatment.
• The woman has heavy bleeding.
• Strong pains.

• It is important to keep the uterus for the subsequent carrying of the baby.

The basic all the same factor which inclines doctors to use such method of disposal of a myoma, is a desire of the woman in the subsequent to have children. There are situations where embolization is performed before the operative removal of fibroids, in order to reduce the risk of heavy bleeding.

It should be noted that in our country this method is considered quite new, therefore it is not possible to find specialists in every city who practice such operations.

If embolization of uterine arteries is required for uterine myoma, Kazan can offer such services to its residents and visitors. The City Clinical Hospital No. 7 has experienced doctors and all the necessary equipment for treating this method.

Preparation for embolization

Before sending a woman to this procedure, the doctor will assign some necessary studies:

1. Ultrasound, with its help you can determine the localization, the size of fibroids.
2. Standard blood and urine tests.
3. Take a smear to determine the microflora of the vagina.
4. Oncocytology is conducted to exclude malignancy of cells.
5. Study for infection.
6. A blood test for HIV, hepatitis C and B.
7. Examination of the cervix under a microscope.
8. A cardiogram is done.
9. The conclusion of other specialists is required if there are chronic pathologies, and also the therapist.

After all the studies, the direction to embolization is given. On the day of the procedure, it is not recommended to eat and drink, to ensure maximum sterility in the groin, remove the hair. If a woman suffers varicose veins, the doctor should recommend wearing a compression knit even a week before the procedure.

The essence of the methodology

Not everyone understands what embolization of the uterine arteries is in case of uterine myoma, as such procedure is done. Let's figure this out. The whole method of therapy consists of the following stages:

1. Preliminary ultrasound examination of the pelvic organs.
2. Cervical mucus is taken to exclude oncological pathologies, inflammatory diseases. With them, this technique is not used.
3. Then a puncture is made in the inguinal fold, and a catheter is inserted into the femoral artery. The procedure is not very painful, so enough local anesthesia.
4. The doctor under the control of radiography conducts the catheter to the place of the uterine artery, where it begins to branch, supplying the myoma.
5. To confirm the correctness of the diagnosis and location of the catheter, an arteriogram is carried out-the introduction of a contrast agent.
6. When the correctness of the actions is confirmed, the specialist introduces through the catheter special preparations which, getting into the narrow vessels, clog them, and the blood does not enter the tumor tissues.
7. To completely eliminate the supply of blood to the myoma, a blockage is made on both femoral arteries.
8. At the end of the procedure, a control arteriogram is made.
9. A sterile dressing is applied to the puncture site.

Embolization of the uterine arteries in uterine myomas continues no more than 1.5 hours, usually enough 20 minutes, it all depends on the location of the arteries and the experience of the doctor.

Restoration of the body after embolization

The female body spends about two weeks to recover after this procedure, but this does not mean that all this time will have to stay in the hospital. After the embolization of the uterine arteries (EMA) in uterine myomas is performed, a woman can go home on the same day if her condition is normal. At home, you must follow certain recommendations:

• It is desirable to have bed rest for several days.
• To relieve pain, you can take painkillers.
• Control the temperature of the body in time to recognize the onset inflammatory process.
• After the procedure, it is desirable to increase fluid intake, especially in the first week.
• If there is fibroids, embolization involves the exclusion of "Aspirin" and other drugs that dilute blood.
• In the early days it is undesirable to take a bath, visit a sauna or a bath.
• For several weeks, full physical rest and exclusion of sexuality is recommended.
• Women in critical days are not recommended to use tampons.

It is very important to conduct timely treatment of uterine fibroids, uterine artery embolization will help a woman to maintain fertility.

The advantages of this method

Any method of treatment has its advantages and disadvantages, embolization is no exception. But first, let's look at the pros:

1. High efficiency.
2. Embolization of uterine arteries with uterine myomas does not leave behind scars and cuts.
3. This method virtually eliminates the re-development of fibroids, which can not be said about prompt removal.
4. Since only local anesthesia can be used, the recovery period is short and does not take much time to break away from anesthesia.
5. In a hospital, a woman can spend only a couple of days.
6. If a fibroid is diagnosed, embolization comes to the rescue if surgical intervention is excluded.
7. The procedure does not adversely affect the childbearing function.

Disadvantages of embolization

Now a little about the minuses. At present, the equipment for carrying out such a procedure is quite expensive. And experts in this area in Russia is still not enough.

Another disadvantage is the use of radiography during the embolization. But it must be noted that the dose of radiation does not exceed the dose that we get when passing the chest X-ray.

The inability to take tissues for a biopsy can be considered a disadvantage, but it is compensated by diagnostic angiography before the procedure. An experienced physician in the vascular picture can always recognize an oncological neoplasm.

Contraindications to the procedure

Despite the fact that embolization of the uterine arteries under uterine myoma is positive, and is also a fairly effective procedure, it is not permitted to conduct it in all cases. Contraindications include:

• Inflammatory pathologies of the pelvic organs.
• Presence of allergic reactions to the drug, which is used to clog vessels.
• Pregnancy.

• The presence of malignant neoplasms in the body of any localization.
• If there is kidney failure, then the use of contrast medium is difficult, therefore the procedure is not recommended.

Relative contraindications include:

• Rapid growth of neoplasm.
• The assembly is superficially arranged and has a thin stem.

An experienced doctor, before sending a woman for embolization, will find out all the contraindications.

Complications of the procedure

This procedure is considered less dangerous than surgery, but embolization of uterine arteries in uterine myoma can also have undesirable consequences, among which the following should be noted:

1. Almost always formed at the puncture site of the hematoma. It eventually passes, but you may need a special ointment to speed up the process.
2. Infection. If this happens, then a course of antibiotic therapy is prescribed. Only it is important not to confuse the onset of infection with the natural reaction of the body. Provided that the temperature is high for several days, it is necessary to inform the doctor.
3. Pain sensations in the lower abdomen. It is almost impossible to insure against them, since this pain is associated with the death of myoma cells. Anesthetics will come to the rescue.
4. There can be an intoxication, so the body reacts to the introduction of a contrast medium. It manifests itself in the form of fever and requires the use of anti-inflammatory drugs.
5. Spikes can be formed from the connective tissue, but this happens very rarely.
6. The absence of menstruation is frequent, but gradually within 2-3 months the cycle is restored.
7. Ovarian exhaustion.
8. A rather rare complication is the perforation of the arteries.

If serious complications arise, the patient may need to promptly remove fibroids. But the probability of such an outcome is small, only 1 case per 1000 procedures.

Where is the procedure of embolization

If you study this method of fighting with myoma, most patients, of course, prefer it than surgery. Then the question arises as to where such procedures are done.

I must say that this technique requires expensive equipment, and not all clinics can afford it. This is the first reason that explains why not every hospital, and not every city, can be embolized.

This direction in medicine is relatively new - carrying out operations on blood vessels, so surgeons who would have enough experience and practice to perform such a procedure are still not enough.

In addition, for carrying out embolization, a special X-ray operating theater is required, which is not available in all medical institutions.

If a woman wishes to get rid of myoma in this way, she most likely needs to seek help from a specialized clinic or private reproductive center.

Embolization of uterine arteries with uterine myoma: reviews about treatment

If a woman decides to get rid of fibroids in this way, then it is necessary to be prepared for the fact that the cost of such a procedure is quite large. This is explained by the use of expensive equipment and preparations for insertion into the vessels.

Most patients note that embolization is less traumatic, so after the procedure, the recovery period is short and does not require long hospitalization.

If embolization of uterine arteries is performed in uterine myoma, reviews are also negative. Some women report severe pain during the procedure, and also for several hours after it. In the first day, the temperature can rise and torments of nausea.

Not everyone celebrates complete elimination of pathology, in some cases the fibroid is gradually disappearing, and there are patients who are undergoing surgical intervention.

Even among doctors there is no unambiguous opinion about embolization, there is a group that considers it to be a real panacea, and there are others who consider this technique to be just an alternative to the operation.

The decision on whether to remove the myoma in an operative way or to try to apply embolization should be taken in conjunction with the doctor. It is necessary to take into account all risks and opportunities for the development of complications. At each woman the organism individually reacts to various interventions, therefore it is impossible to assert that absolutely any one will approach this or that way of treatment.