Virtual Mentor. May 2003, Volume 5, Number 5.
Treating Uterine Fibroids
Uterine artery embolization is an alternative to a hysterectomy that is safe, effective, and less costly for treatment of uterine fibroids.
Audiey Kao, MD, PhD
Uterine leiomyomas or fibroids are benign tumors of the uterus that develop in up to 25 percent of women . Significant morbidity from uterine fibroids include prolonged or heavy menstrual bleeding, pelvic pressure or pain, and, in rare cases, reproductive dysfunction .
Surgery has been the mainstay of fibroid treatment, and in fact, uterine fibroids are the most common indication for hysterectomies. Treatment with gonadotropin-releasing hormone agonists, alone or in combination with more conservative surgical treatments, such as myomectomy or myolysis, are also used.
More recently, patients have a less invasive option than hysterectomy—uterine artery embolization (UAE). Studies have found that UAE is safe, effective for the treatment of fibroids and less costly than a hysterectomy [3-7]. Some patients, however, may not be good candidates for UAE such as patients who:
UAE interrupts the uterine blood supply by injecting agents such as polyvinyl alcohol articles. As seen in Figure 1, the pre-embolectomy angiogram shows the uterine arterial blood flow (arrows designate the uterine arteries), while in Figure 2, the post-embolectomy angiogram reveals no further blood flow through the right or left uterine arteries.
Side effects and complications of UAE include:
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