Embolization of the uterine arteries with uterine myoma: treatment and consequences

One of the branches of medicine is reproductive. She is one of the most delicate, as 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 a fairly large number of women suffer from various inflammatory and infectious diseases of the reproductive system, which often causes infertility or the inability to endure a baby.

Most often, uterine fibroids are found among all pathologies. It can cause infertility, every year medicine moves further and further, completely new methods of therapy appear that can bring women closer to their cherished goal.

One of these modern methods is the embolization of the uterine arteries with uterine myoma. We will get acquainted with this method of getting rid of fibroids in our article.

What is uterine fibroids?

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

The disease is quite simply recognized by an ultrasound examination, but even before a doctor visits, a woman can feel pain in the lower abdomen, a violation of the urination process. Many have uterine bleeding, which some try to pass off as irregular menstruation.

Most often, women of reproductive age suffer from this pathology, if delayed with treatment, then it is not far from infertility and other complications.

The essence of the method

Embolization of the uterine arteries with uterine myoma is a new method of treatment of this disease, which allows you to get rid of the neoplasm without resorting to surgery. Complications after such an intervention are rare, so the method is considered the most sparing and quite effective.

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

When embolization is prescribed

For many women, the question arises: "If there is a neoplasm, then is the uterine artery embolization with uterine fibroids when prescribed?" Are there any contraindications to this procedure? First, we will analyze the readings, and such are:

• Myoma is growing steadily.
• There is no possibility of surgical treatment.
• The woman has heavy bleeding.
• Severe pain.

• It is important to save the uterus for subsequent bearing of the baby.

Still, the main factor that prompts doctors to use just such a method of getting rid of fibroids is the woman’s desire to subsequently have children. There are situations when embolization is performed before the surgical 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, not every city can find specialists who practice such operations.

If embolization of the uterine arteries with uterine myoma is required, Kazan can offer such a service to the services of its residents and visitors. In the city clinical hospital No. 7 there are experienced doctors and all the necessary equipment for treatment with this method.

Preparing for embolization

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

1. Ultrasound, with its help, you can determine the location, size of fibroids.
2. Standard blood and urine tests.
3. A smear is taken to determine the vaginal microflora.
4. Oncocytology is performed to exclude cell malignancy.
5. Research for infection.
6. A blood test is performed for HIV, hepatitis C and B.
7. Examination of the cervix under a microscope.
8. A cardiogram is being made.
9. The conclusion of other specialists is required if there are chronic pathologies, as well as a therapist.

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

The essence of the methodology

Not everyone understands what embolization of the uterine arteries with uterine myoma is, how to do such a procedure. Let's look into this issue. The whole method of therapy consists of the following steps:

1. Preliminary ultrasound examination of the pelvic organs.
2. A 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 local anesthesia is enough.
4. The doctor, under the control of radiography, conducts a catheter to the uterine artery where it begins to branch, supplying the myoma.
5. To confirm the correct diagnosis and the location of the catheter, an arteriogram is performed - the introduction of a contrast medium.
6. When the correctness of the action is confirmed, the specialist introduces special preparations through the catheter, which, getting into the narrow vessels, clog them, and the blood does not enter the tumor tissue.
7. To completely exclude the blood supply to fibroids, blockage is done 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 with uterine myoma continues for no more than 1.5 hours, usually 20 minutes is enough, it all depends on the location of the arteries and the experience of the doctor.

Recovery after embolization

The female body takes about two weeks to recover from this procedure, but this does not mean that all this time will have to remain in the hospital. After uterine artery embolization (EMA) is performed with uterine myoma, a woman can go home almost the same day if her condition is normal. At home, you must follow some recommendations:

• It is advisable to bed for several days.
• To relieve pain, you can take painkillers.
• Monitor body temperature in order to timely recognize the onset of an inflammatory process.
• After the procedure, it is advisable to increase fluid intake, especially in the first week.
• If there is a fibroid, embolization involves the exclusion of Aspirin and other blood-thinning medications.
• In the early days it is undesirable to take a bath, visit a sauna or bath.
• For several weeks, complete physical rest and the exclusion of sexual activity are recommended.
• Women are not recommended to use tampons on critical days.

It is very important to conduct timely treatment of uterine fibroids, embolization of the uterine arteries will help a woman maintain the ability to bear children.

Pros of this method

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

1. High efficiency.
2. Embolization of the uterine arteries with uterine myoma does not leave scars and cuts.
3. This method virtually eliminates the re-development of fibroids, which can not be said about surgical removal.
4. Since only local anesthesia can be used, the recovery period is short and does not require much time to move away from anesthesia.
5. In the hospital, a woman can spend only a couple of days.
6. If fibroids are diagnosed, embolization comes to the rescue if surgery is ruled out.
7. The procedure does not adversely affect fertility.

Disadvantages of embolization

Now a little about the cons. Currently, the equipment for such a procedure is quite expensive. And there are still not enough specialists in this field in Russia.

Another disadvantage is the use of radiography during embolization. But it should be noted that the dose of radiation does not exceed that which we receive by undergoing chest x-ray.

The disadvantage can be considered the inability to take tissue for biopsy, but it is offset by a diagnostic angiographic study before the procedure. An experienced doctor can always recognize an oncological neoplasm by the vascular picture.

Contraindications to the procedure

Despite the fact that embolization of the uterine arteries with uterine fibroids has positive reviews, and is also quite an effective procedure, it is not allowed to carry out it in all cases. Contraindications may include:

• Inflammatory pathologies of the pelvic organs.
• The presence of allergic reactions to the drug, which is used for blockage of blood vessels.
• Pregnancy.

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

Relative contraindications include:

• Rapid growth of the neoplasm.
• The node is superficial and has a thin leg.

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

Complications of the procedure

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

1. Almost always formed at the site of a hematoma puncture. It passes over time, but a special ointment may be required to speed up the process.
2. Infection. If this happens, then a course of antibacterial therapy is prescribed. It is only important not to confuse the onset of infection with the natural reaction of the body. Provided that the temperature is high for several days, you will have to inform your doctor.
3. Pain in the lower abdomen. It is almost impossible to insure against them, since this pain is associated with the death of myoma cells. Painkillers will come to the rescue.
4. There may be intoxication, as 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. Adhesions from connective tissue can form, but this happens extremely rarely.
6. The absence of menstruation is often, but gradually in 2-3 months the cycle is restored.
7. Ovarian exhaustion.
8. A rather rare complication is perforation of the arteries.

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

Where is the embolization procedure performed?

If you study this method of combating fibroids, then most patients, of course, would prefer it than surgery. Then the question arises of where such procedures are done.

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

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, a special X-ray operating room is required for embolization, which is not available in all medical institutions.

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

Uterine artery embolization with uterine myoma: treatment reviews

If a woman decided to get rid of fibroids by this method, then it is necessary to be prepared for the fact that the cost of such a procedure is quite high. This is due to the use of expensive equipment and drugs for administration into the vessels.

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

If embolization of the uterine arteries is carried out with uterine myoma, reviews are also negative. Some women report severe pain during the procedure, as well as for several hours after it. On the first day, the temperature can rise and torment attacks of nausea.

Not everyone notes a complete elimination of the pathology, for some the fibroid really disappears, and there are patients who have surgery.

Even among doctors there is no unequivocal opinion about embolization, there is a group that considers it a real panacea, and there are also those who consider this technique to be just an alternative to surgery.

The decision to remove the fibroids in an operative way or to try to apply embolization should be made in conjunction with the doctor. All risks and opportunities for the development of complications must be considered. For every woman, the body individually responds to various interventions, so it cannot be argued that one or another method of treatment is suitable for absolutely everyone.