Interventional therapy in obstetrics and gynecology

  1.Q: What is interventional technology?  A: Interventional technology is a minimally invasive diagnosis and treatment technology that has been flourishing in recent years. It involves entering the body cavity, such as the abdominal cavity or blood vessels, with the help of certain small instruments or apparatus to complete certain operations for diagnostic and therapeutic purposes, commonly known as interventional ultrasound technology, interventional endoscopic technology, interventional radiology technology, etc. What we are referring to here is vascular radiological interventional technology, which is to treat diseases by inserting tiny catheters and guidewires into selected blood vessels under the guidance of X-ray imaging equipment, specifically for the treatment of obstetrical and gynecological diseases, the main procedure is uterine artery embolization.  2.Q: What are the obstetrical and gynecological diseases that can be treated by interventional techniques?  A: Interventional technology was first applied to the treatment of gynecological malignancies in 1950, and after nearly 50 years of research, it is now widely used in various fields of obstetrics and gynecology. For cancer patients, it can improve the ability to kill cancer cells by injecting anti-cancer drugs directly into the blood supply vessels of tumors and embolizing these vessels, which greatly improves the prognosis of tumor patients. In benign gynecological diseases, it can be used for uterine fibroids, adenomyosis, tubal pregnancy, cervical pregnancy and refractory functional uterine bleeding. It has become the preferred alternative to hysterectomy for uterine fibroids in developed countries. It can be used in adenomyosis to relieve intractable dysmenorrhea, excessive menstruation and reduce the size of the enlarged uterus; in rare cervical pregnancy, it can cause ischemia, necrosis and resorption or dislodgement of the abnormal growth, avoiding In rare cases of cervical pregnancy, it can cause ischemia, necrosis and resorption or dislodgement of the abnormal growths, avoiding the outcome of hysterectomy due to haemorrhage. In obstetrics, it can be applied to severe postpartum hemorrhage where drug treatment is ineffective, and has an immediate effect on hemostasis, saving the patient’s life and avoiding the trauma of hysterectomy.  3.Q: What is the difference between interventional treatment and general surgical treatment?  A: The most obvious advantage of interventional treatment for obstetric and gynecological diseases compared with traditional surgery is its minimally invasive nature. First of all, the incision is tiny, only a 2mm (grain of rice) puncture is made at the skin of one thigh, which is minimal compared to the incision of about 10-15cm in general open surgery. Secondly, the damage to the body is minimal and the recovery is fast. The interventional procedure takes 30-60 minutes on average and requires only local anesthesia, no abdomen opening, no organ removal, almost no bleeding or only a few milliliters during the whole procedure, and you can walk freely one day after the procedure. In addition to minimally invasive, interventional treatment also has the advantage of preserving the female reproductive organs. For severe postpartum hemorrhage, uterine fibroids, adenomyosis and other diseases, the traditional surgical treatment methods, whether transabdominal, transvaginal or laparoscopic, are mainly hysterectomy, while interventional treatment is achieved by inserting a tube into the uterine artery for injection of drugs or embolization, without removing the uterus, preserving an extremely important organ for women, which is of great significance.  4.Q: Will the whole uterus become necrotic or affect the endocrine function if the blood supply artery of the uterus is embolized by interventional treatment?  A: No, as observed by the research, although interventional treatment embolizes the uterine artery, only the tumor cells with high oxygen requirement are necrosed, and the normal uterine muscle cells can be supplied with blood through the opening of other small blood vessel branches without necrosis. Interventional treatment basically has no effect on the endocrine function of women, and normal menstrual cycle can be restored after the operation.  5.Q: What is the development direction of interventional therapy in the field of obstetrics and gynecology?  A: With the popularization of interventional technology, it is expected to become the preferred treatment for benign diseases such as uterine fibroids and adenomyosis in the future, which not only treats the disease but also preserves the uterus to meet the needs of patients and benefit the majority of women.