Contraindications for uterine artery embolization for uterine myoma
Uterine artery embolization - a new one, but quite popular minimally invasive techniques, the essence of which is the cessation of blood flow in the branches of the uterine arteries feeding the fibroids. The procedure allows to work on all the nodes with multiple lesions, performed under local anesthesia, and provides long-term preservation of the quality of life of patients.
The indications for uterine artery embolization
This method is used for the treatment of asymptomatic or clinically significant myomatous tumors. Uterine artery embolization may serve as a preparatory step prior to myomectomy. This treatment is preferred in patients with severe somatic uterine bleeding, as compared with surgical intervention can significantly reduce anesthetic and surgical risk.
Contraindications to UAE
Contraindications for the UAE include pregnancy, cancer, infectious pathology of active pelvic inflammatory processes in the endometrium, the presence of subserous myoma node on a thin stalk.
Inability to perform X-ray studies due to renal failure, kinking of iliac vessels, intolerance to contrast medium. Relative contraindications include cervical myoma and submucous location of a node on a thin stem, in view of what is possible in this case an alternative method of treatment gisterorezektoskopichesky.
Uterine artery embolization
The technique of uterine artery embolization
Uterine artery embolization is performed under rentgenkontrolem. It consists in catheterization and subsequent occlusion of the arteries supplying the tumor, by introduction of embolizing material. Blockage of these vessels leads to the development of ischemia followed by sclerosis, necrosis, hyalinosis, and calcification of all existing myoma nodes.
Duration of treatment can vary from 15 minutes to 1.5 hours, this is due to anatomic and technical features in each individual case and does not affect the result.
The postoperative period
After 1-2 hours after the manipulation of patients may experience moderate pain in the abdomen pull character. In most cases, are already on the next day and the pain decreases within 5-7 days fully docked (depending on the volume of embolized tissue).
In some cases, perhaps the presence of bleeding from the vagina, which may be a cause of ischemic drainage through the intervention of small submucous fibroids in the uterus. These symptoms require the use of traditional antibiotics, antipyretics, and relatively rapidly. The patient may be discharged when the normalization of the temperature and the disappearance of pain on the second or third day.
After 1, 3, 6 and 12 months after the procedure is carried out in order to control an ultrasound. In the future, it must be carried out once every 12 months.
Complications after uterine artery embolization
Complications after uterine artery embolization in the form of amenorrhea and separation of tissues decomposing fibromatous node are rare.