Uterine fibroids are formed by the proliferation of uterine smooth muscle cells and are pathologically characterized by substantial spherical nodules of varying sizes. The tumor is surrounded by a pseudo-envelope composed of compressed muscle fibers, and there is loose connective tissue between the pseudo-envelope and the fibroid. It is common to see edema, vitreous degeneration, cystic degeneration, calcification, and rarely red degeneration and sarcoma.
Former U.S. Secretary of State Condoleezza Rice was discharged from Georgetown University Hospital on November 19, 2004, in good condition after undergoing embolization of a fibroid under local anesthesia and being hospitalized for one night for observation. Her attending physician, interventional radiologist Dr. James Spies, was interviewed after the procedure. In a post-operative interview, Spies said: “So far, everything is fine, it’s a routine procedure, and the techniques are well established.
Fibroids, also known as uterine fibroids, are the most common benign gynecologic tumor in gynecology and are known as the “number one tumor in women. There are various treatment options, including hysterectomy and myomectomy. The procedure chosen for Ms. Rice is called “uterine artery embolization”, which is a type of vascular intervention. The specific treatment method is to cut a small opening of the size of a grain of rice at the root of one thigh and apply a special catheter to embolize the blood supplying artery of the fibroid to make the fibroid ischemic and anoxic necrosis and absorption, so as to achieve the purpose of treating the fibroid, which is a new and mature fibroid treatment method.
(1) the nature of love of beauty. The reason for this is that the uterus and ovaries are connected by blood vessels, and the uterus provides 50%-70% of the blood supply to the ovaries. Removal of the uterus affects the endocrine function of the ovaries, and it has been found that the uterus itself secretes some estrogen. Uterine artery embolization for uterine fibroids preserves the uterus and its normal uterine functions while causing the fibroids to die and disappear, which is the biggest difference from traditional surgery.
(2) High demand for quality of life. The uterus is anatomically located in the center of the pelvic floor and is connected to the pelvic wall by ligaments, which play a role in fixing the pelvic floor structure. A good pelvic floor structure is an important factor to ensure that the pelvic organs are fixed in place. When the pelvic floor structure is damaged, prolapse of the internal organs occurs, most commonly in women, vaginal laxity and urinary incontinence due to bladder prolapse.
(3) This procedure has many advantages. Compared with traditional surgical treatment, uterine artery embolization for uterine fibroids has the advantages of precise efficacy, small trauma, no incision, quick recovery, low recurrence rate, and preservation of the uterus. The failure rate of this procedure is about 1% after searching relevant data at home and abroad.
Patients with uterine fibroids suitable for uterine artery embolization.
1, bleeding caused by uterine fibroids (heavy menstrual flow and prolonged menstrual period).
2. back and abdominal pain caused by fibroids.
3. distension and pain in the pelvic area caused by fibroids and symptoms of rectal compression.
4.Recurrence of fibroids after myoma removal, with symptoms excluding malignant change.
Patients with uterine fibroids who are not suitable for uterine artery embolization.
1, the presence of contraindications to angiography, including dysfunction of the heart, liver, kidney and other important organs, and abnormal coagulation mechanisms.
2. those with acute or chronic gynecological inflammation that has not been effectively controlled.
3, other relative contraindications including postmenopausal, severe atherosclerosis and advanced age patients.
4, uterine arteriovenous fistula.
Prevention of adverse reactions and complications after uterine fibroid embolization.
1, pain: pain is a common intraoperative and postoperative adverse reaction, which may be related to the degree of embolization of the embolization agent into the pathological vascular bed of the fibroid. To effectively reduce intraoperative pain, dexamethasone plus saline is slowly pushed through the catheter and dulcolax is injected intramuscularly before surgery. Postoperative pelvic pain is the most prominent reaction after uterine fibroid embolization treatment. Symptomatic treatment generally disappears in 2-14 days, and the degree and duration of pain are positively correlated with tumor size.
2.Nausea, vomiting and fever: improve and disappear after 3-5 days of symptomatic treatment.
3.Routine application of antibiotics after surgery to prevent infection: endometritis, pus accumulation and uterine perforation are the most serious complications after uterine artery embolization. To prevent complications, its key to control infection, antibiotics are routinely given for 3-6 days, which can be extended for those with large myoma.