Uterine fibroids: uterine artery embolization

Fibroids are not a reason for removal of the uterus. Modern methods of non-surgical treatment of fibroids allow women to preserve the uterus and to plan pregnancy. One method of treatment is uterine artery embolization, which is widely used in the treatment of uterine fibroids and other diseases.

Surgery or embolization?

Still in Ukraine and countries of the former USSR in the diagnosis of fibroids many women removes the uterus. However, not everyone knows that there are effective and organ-preserving methods of treatment of fibroids that preserve the uterus and to allow the women to plan pregnancy.

Many believe that uterine artery embolization (UAE) is a new method. However, it is used since 1979. In other words, this technique was used before the advent of laparoscopy, which for many years used in operative gynecology.

For the treatment of uterine fibroids uterine artery embolization was used in the early 90-ies. After its successful application it has been widely used in a large number of medical institutions in Europe, USA and Asia and the Middle East. In 1996, the FDA approved this treatment, and the EMA has received official permission in the United States.

Associated diseases:

The uterine leiomyoma (fibroids, myomas) Leiomyoma of the uterusFibroids

Junction of uterine myoma: treatment

Uterine artery embolization: the technique

Uterine arteries are the main source of blood supply to the uterus, but the organ receives its blood supply from other arteries. The technique of EMA lies in the cessation of blood flow through the uterine arteries. In this case the branches of the arteries that supply blood to the healthy part of the uterus, without hurting. Such a selective termination of blood flow is possible due to the peculiarities of blood supply of the fibroids.

Myoma of the uterus supplied with blood vessels which diameter does not exceed 0.5 mm. It is several times more than the normal vessels of the myometrium. And after the introduction of these vessels embolization particles, fibroids stop blood flow and gradual replacement by connective tissue. Fibrosis fibroids leads to a significant reduction of its size, and sometimes to its complete disappearance.

Fibroids is not so scary

How is uterine artery embolization in uterine fibroids

Embolization of uterine arteries in uterine fibroids is performed in specially equipped rooms, which is an apparatus for angiography. It is noteworthy that the embolization is performed by gynecologists and endovascular surgeons. Specialists who perform uterine artery embolization, should be qualified in the field of vascular surgery and radiology.

Embolization is a painless procedure that is performed under local anesthesia. To access the vasculature, make a puncture in the femoral artery. After that, through a catheter introduced embolization of the drug particles (microspheres), which blocks blood vessels that feed the fibroids. Usually embolization particles are introduced alternately in the right and left uterine artery.

Uterine artery embolization for the duration can last from 10 minutes to 2 hours. It all depends on the experience of the surgeon and of origin of the uterine artery. Most often the procedure lasts no more than 20-30 minutes.

During the procedure, a woman has no feelings, it is sometimes possible periodic occurrence of heat or burning in the abdomen and lower back. Such feelings arise due to a contrast agent that enters the surgeon to visualize the vessels.

The results and benefits of uterine artery embolization

After conducting EMA women have normalized the symptoms. In particular, after the intervention comes to normal menstrual bleeding, reduced the volume and duration of bleeding. Disappear symptoms of compression, reduces the size of fibroids and the overall uterine size (this process takes up to 6-8 months after embolization). A year after embolization, the volume of nodes is reduced more than 4 times, and fibroids of small sizes disappear completely.

One of the important features of uterine artery embolization is no risk of relapse after the intervention. This is due to the fact that the procedure affects to all nodes, regardless of their size. It is noteworthy that in the long term, more than 98% of women undergoing EMA, do not need any additional treatment of uterine fibroids.

The main advantages of uterine artery embolization are:

  • Safe and minimally invasive therapeutic method that does not require General anesthesia.
  • The effectiveness of EMA in more than 98% of cases.
  • Immediate improvement of symptoms.
  • The absence of recurrence.
  • A short stay in the clinic (only 1 day).
  • Low probability of complications.
  • Preservation of the uterus.
  • The preservation plan for the child.

Uterine artery embolization: what can be complications

Embolization of uterine fibroids is considered a very safe procedure and the risk of complications in this case, the minimum does not exceed 1%.

The most common problem of EMA, the appearance of hematoma (bruise) on my hip the place where was carried out puncture of the artery. It’s quite a small complication that does not require additional therapeutic measures. Typically, the bruise disappears within 1-2 weeks.

3% of patients after uterine artery embolization disturbances of the menstrual cycle, which will eventually pass.