Interventional treatment of adenomyosis

Same as fibroids, uterine artery embolization is used to treat fibroids. The principle of the treatment is to cause necrosis and absorption of the lesion in the uterus by embolizing the uterine artery. After the uterine artery is embolized, the lesion will undergo the following changes: 1. Due to the loss of blood supply, the ectopic endothelium and hyperplastic connective tissue will be necrotic due to lack of blood supply and oxygen, and then gradually dissolve and be absorbed, so that the lesion will be reduced in size or even disappear. 2. 2. After the lesion shrinks, the irritating substances released by the lesion that make the uterus contract will be reduced, thus improving the symptoms of dysmenorrhea. 3. When the lesion shrinks, the uterus becomes softer, the volume of the uterus and the area of the uterine cavity decrease accordingly, and the amount of menstruation can be reduced accordingly. 4. After the necrosis of ectopic endometrium, the necrotic part will be closed, and the myometrium will press the original tiny channel due to the corresponding reduction in volume, resulting in its closure, and the normal endometrium will also lose the channel to enter the myometrium. This greatly reduces the possibility of recurrence. 5. The necrosis of ectopic endometrium reduces the amount of local estrogen and its receptors. The necrosis of the ectopic endometrium reduces the amount of local estrogen and its receptors, so that the vicious circle of the spread of adenomyosis can be controlled. It also eliminates one of the possible disease factors of adenomyosis and reduces the possibility of recurrence. 6.After embolization, although the normal endometrium may have mild necrosis, it can regrow and resume normal function after blood vessels are reopened or collateral circulation is established. On the other hand, ectopic endothelium is unable to regrow after necrosis due to the lack of support from the basal layer. Clinical efficacy Dysmenorrhea relief rate: 70% to 90% of the patients showed significant or obvious improvement of dysmenorrhea symptoms within 1 to 3 months after the intervention. More than 89% of the patients had reduced menstrual flow after the intervention, especially for those with hemorrhagic anemia due to excessive menstruation, the menstrual flow could be reduced to 20%~80% of the preoperative level. For patients with fertility requirements, most of them can have normal pregnancy after the procedure. Anemia, patients with anemia symptoms can usually recover to normal or near normal hemoglobin level after 3 months after surgery, i.e. anemia is effectively corrected. Gynecological examination: uniformly enlarged and hard uterus is the characteristic of this disease. Gynecological examination 1~6 months after the interventional therapy can find that the uterus becomes softer and smaller than before the surgery. Change of vaginal secretion: some patients with adenomyosis had excessive leukorrhea and blood before the intervention, or various vaginitis caused by repeated infections due to increased leukorrhea. They are completely cured after the intervention. Improvement of other symptoms: Improvement of sexual life quality, disappearance of facial acne and chloasma. Post-operative review: Ultrasound and MRI can be used from three months to sixty-one years after the procedure to understand the changes in the size and volume of the uterus and the lesion.