- Embolization of uterine fibroids: preparation
- Embolization: the course of the treatment
- After the embolization of uterine fibroids
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Embolization is a good way to get rid of uterine fibroids. Almost every second woman over 35 has uterine fibroids. Until recently, the only treatment option was to excise the nodules or the entire reproductive organ. Today, uterine fibroids can be starved to death thanks to embolization - a method of treating uterine fibroids.
Embolization , which cuts off the blood supply to tumors that, cut off from their oxygen and nutrient supply, starve to death, is an alternative to traditional methods of getting rid of fibroids.
The surgery to remove the fibroidsmay also involve their removal (myomectomy), which does not guarantee that no new ones will appear, or the removal of the entire uterus (hysterectomy). The decision about the method of getting rid of fibroids depends on the patient and the doctor.
Embolization of uterine fibroids: preparation
Before a woman arrives for the procedure, she should take a vaginal smear, cytology and - if she is over 40 years old and the endometrium, i.e. the endometrium thicker than 8 mm - mucosal histology (microscopic examination of cells collected in the form of scrapings from the uterine cavity).
Transvaginal ultrasound is welcome. Blood tests and magnetic resonance imaging are already performed in the hospital. Embolization is performed after menstruation, but before the 14th day of the cycle (remember that the first day of the cycle is the first day of bleeding).
The procedure is excluded if the woman has an intrauterine device. You must fast on the day of the procedure, so the last meal is dinner the previous day. In the morning, you can only drink medications that we take constantly and a sedative. We get an antibiotic intramuscularly and vaginally.Important
Uterine fibroids can be single, but there can be even several dozen of them. They can reach the size of a nice melon. A distinction is made between myomas: submucous - those that develop inside the uterus, intramural - grow in its wall, subserous - outside. Some, called pedunculate, grow on the "leg" of the connective tissue - both inside and outside the uterus.
Embolization: the course of the treatment
You have to undress and lie on your back. The nurse will cover us with sterile scarves and shave our right groin. The place above the femoral artery is disinfected with an alcohol solution to inject a local anesthetic there (during the procedure we do not feel pain, only touchsurgeon's hand).
The doctor punctures the artery and inserts a catheter into it - a flexible, plastic tube with a diameter of about 1.2 mm. Through it, he gives a shading agent (the so-called contrast). We feel warmth in the abdomen, which is a normal reaction. You don't have to move then. Thanks to the contrast, you can clearly see the artery on the monitor.
The catheter is inserted further - into two uterine arteries and through them the so-called PVA embolization preparation for vessels that supply the myoma with blood. As a result, these vessels close.
During the procedure, the patient does not feel pain because the blood vessels do not have pain receptors on the surface of the inner wall. The procedure does not require general anesthesia. Catheter movements are not felt, but only… visible on the monitor.
After the procedure, which lasts 30-40 minutes, the doctor removes the catheter, compresses the puncture site and applies a pressure dressing for three hours. After the morning treatment, usually by 20 it is not allowed to stand up, sit down or bend the right leg. The idea is to prevent a hemorrhage or a clot forming that could break off and clog the artery.Don't do that
Contraindications to embolization:
- pedunculated fibroids,
- infections (genital, pelvic and general),
- allergic to contrast agents,
- chronic renal failure,
- untreated thyroid diseases,
- some mental illnesses.
After the embolization of uterine fibroids
You can drink and eat as early as 3-4 hours after the treatment. Usually, after the lapse of a day, patients return home. Half of them experience slight spotting for 1-3 days, and their first periods may be faster. A high temperature or slight pain in your lower abdomen may remain for a month (over-the-counter painkillers will help).
If the pain persists, the fever is rising or an unpleasant-smelling vaginal discharge appears - you need to contact the doctor performing the procedure (we get his telephone number at the hospital). Fortunately, such complications occur in only about 2% of patients. women.
After three months, menstruation returns to normal, and the pains in the lower abdomen disappear. At this time, we come to the center for MRI where the embolization was performed. And then it usually turns out that the myoma (or fibroids, because you can dry several at the same time) has been reduced by half. Then it decreases further and no longer grows back.
Women who did not have a baby because of tumors usually get pregnant within a year after embolization.
It is best to embolize fibroidsuterus:
- submucosal, intramural, subserous,
- occurring in numbers,
- 3-4 cm in diameter (if there are abnormal bleeding),
- with a diameter of 5-10 cm (then the treatment is the most effective),
- with a diameter of 11-18 cm (waiting longer with the procedure increases the risk of complications).