Uterine fibroids are common benign tumors in gynecology, mostly seen in women aged 30-50 years old, and according to statistics, at least 20% of women of childbearing age suffer from fibroids. In recent years, uterine artery embolization intervention for uterine fibroids has become a popular treatment method for uterine fibroids because of its advantages of less trauma, preservation of uterus and good effect, and has been rapidly promoted nationwide.
I. What are the symptoms of uterine fibroids?
Most people have no symptoms, and some patients may have the following manifestations.
1. Bleeding: the most important symptom of uterine fibroids, mostly manifested as increased menstrual flow, prolonged periods or shortened cycles. A small number of people may show irregular vaginal bleeding that does not have a menstrual cycle.
2, abdominal mass and compression symptoms: Larger fibroids may show this symptom, and in serious cases, compression of bladder may cause dyspareunia, compression of rectum may cause dyspareunia, compression of ureter may cause hydronephrosis.
3.Pain: Generally, it does not cause pain. Very few patients may have lower abdominal swelling and back pain. Those with uterine fibroids combined with adenomyosis may have dysmenorrhea.
4.Increased leucorrhea: The enlarged uterine cavity, increased endometrial glands, and pelvic congestion may increase leucorrhea.
5.Infertility and miscarriage: Some patients with uterine fibroids may be infertile or prone to miscarriage.
6.Anemia: Long-term excessive menstruation or irregular vaginal bleeding may cause blood loss anemia.
Do uterine fibroids have to be treated?
Not necessarily.
If patients have no obvious symptoms and no signs of malignancy, they can be followed up regularly for observation.
What are the advantages of uterine artery embolization intervention for uterine fibroids?
1.Efficacy: It has good effect on most uterine fibroids, and the fibroids shrink significantly after embolization and remain stable, with low recurrence rate.
2.Little trauma: compared with traditional surgery, it is only a small needle eye in the leg and no need to change medicine and disinfection.
3.Uterine function and normal reproductive function can be preserved.
4.Short hospitalization days and fast recovery: usually 2-3 days can be observed after the operation, and it usually can return to normal within 1 week.
What kind of uterine fibroids can be treated by uterine artery embolization?
Not all uterine fibroids need uterine artery embolization intervention, the following cases can be considered.
1, women of childbearing age, before menopause.
2.Uterine fibroids are clearly diagnosed and cause related symptoms.
3. Those whose conservative drug treatment is ineffective or recurrent.
4.Those who require preservation of the uterus.
5.Those who have no symptoms but have high psychological pressure.
What kind of uterine fibroids cannot be treated by uterine artery embolization?
Not all uterine fibroids can be treated by uterine artery embolization, the following cases are not suitable.
1.Persons who are clearly pregnant.
2.History of allergy to contrast media.
3.Subplasmic fibroids with thin tissues, broad ligament fibroids and free fibroids.
4.Suspected of malignant change.
Can the uterus be necrotic after uterine artery embolization for uterine fibroids?
No, it will not. This is determined by many aspects.
First of all, besides the uterine artery as the main source of blood supply, the uterus also receives blood supply from several blood vessels, which is one of the multi-vascular organs in human body. When the uterine arteries are embolized, the uterine fibroids are not supplied with blood from the network of blood vessels, and thus will be necrotic.
Secondly, the normal uterus is in a resting state in adult women and has a high tolerance to ischemia and hypoxia, while fibroids are new tumors and the fibroid cells are in a constant state of division and need more nutritional blood supply, and have a lower tolerance to ischemia and hypoxia.
Therefore, after embolization of uterine artery, the fibroids will become degenerative and necrotic while the uterus will not.
After embolization of uterine artery for uterine fibroids, will it recur?
It should be said that there is no guarantee that the fibroids will not recur, but the chance of recurrence is very low.
According to foreign tests, the local estrogen level of fibroids is 20% higher than that of normal myometrium, and the utilization of estrogen is also 20% higher, meanwhile, fibroid cells will secrete a certain amount of estrogen during the growth process, which will also stimulate the surrounding myometrium while supplying the growth of fibroid cells. As a result, fibroids are predominantly multiple. After embolization of the uterine artery, the fibroids become necrotic, resulting in the loss of estrogen secretion and stimulation of the surrounding normal myometrial tissues. Therefore, in clinical practice, we can find that no recurrence of fibroids or very low recurrence rate is seen for a long time after uterine artery embolization.
Do fibroids remain in the body after uterine artery embolization?
After uterine artery embolization, fibroids remain in the uterus, but they are eliminated in the following ways.
Submucosal fibroids may be expelled vaginally after embolization. Small fibroids may be expelled as vaginal drainage, while large fibroids may be expelled directly from the vagina, sometimes requiring physician-assisted clamping.
Other types of fibroids are absorbed by the body and excreted through the kidneys.
Is it true that the pain after uterine artery embolization is very severe?
Abdominal pain can occur after uterine artery embolization, but the degree of pain varies from person to person. It usually lasts for a few days, and in a few cases, it may last for a few weeks. Oral pain medication is sufficient in routine cases.
Does the preservation of the uterus after embolization of uterine fibroids mean that fertility is guaranteed?
In the absence of large-scale randomized controlled clinical studies, the prevailing view is that the conception rate of patients after embolization of uterine fibroids is comparable to that of the general population, and the impact on patients’ reproductive function is minimal. However, considering individual differences, there is no way to guarantee that fertility will not be affected, but it is clear that surgical resection for fertility is not possible, while interventional embolization is only likely to affect it.