Uterine fibroids are common benign tumors of the reproductive system in women of childbearing age, with an incidence of 20%-25%. Patients may have varying degrees of pelvic pain, uterine bleeding, abdominal distention, bladder rectum and other pressure symptoms.
The traditional treatment methods are mainly as follows
1, drug treatment. It is mainly hormone therapy, which is effective in shrinking fibroids and reducing symptoms, but the course of treatment is long and slow, and the long-term application of toxic side effects is great.
2, surgical treatment. Myoma removal has a high recurrence rate of 25%-30%; total hysterectomy is very traumatic and painful, and also has an impact on endocrine, especially young patients who wish to keep the uterus have difficulty in accepting the surgery.
The uterine fibroid embolization procedure that Rice underwent was different from the traditional surgical method, and was a minimally invasive interventional procedure that required no incision. A small 2 mm incision is made in the femoral artery of the patient’s thigh, a very thin catheter is passed along the vessel into the uterine artery, which is then superselected to the fibroid supplying artery, and an embolic agent is injected. In this way, the blood and nutrient supply to the fibroids is blocked and the fibroids are gradually reduced or eliminated for the purpose of treatment. This treatment is less invasive, leaves no scars after surgery, has fewer complications, is quick to recover, and is easily accepted by patients, who can get out of bed the day after surgery. It has become the first choice for patients with uterine fibroids in many countries.
As early as in the 1990s, hospitals in China carried out arterial embolization interventions for uterine fibroids and achieved remarkable results. However, because the word “intervention” is a foreign word, many patients know little about “interventional” therapy, and those who could have received minimally invasive surgery have been subjected to “major surgery” due to lack of medical knowledge. In contrast to hysterectomy, embolization of benign fibroids is minimally invasive, results in rapid recovery, and is more easily controlled.
What kind of fibroids are suitable for uterine artery embolization?
1, bleeding caused by fibroids.
2.lumbar 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 removal of fibroids with symptoms except malignant change.
Which kind of fibroid patients are not suitable for uterine artery embolization?
1, the presence of contraindications to angiography, including dysfunction of the heart, liver, kidneys and other important organs, abnormal coagulation mechanism.
2.Patients with acute and chronic gynecological inflammation that cannot be effectively controlled.
3, other relative contraindications including postmenopausal, severe atherosclerosis and advanced age patients.
4, uterine arteriovenous fistula.
Prevention and control 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 embolic agent into the pathological vascular bed of the fibroid. To effectively reduce intraoperative pain, dexamethasone plus saline is given preoperatively by slow pushing through the catheter and intramuscular injection of dulcolax. 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. It will 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. In order to prevent complications, its key to control the infection and routinely give antibiotics for 3-6 days, which can be extended for those with large myoma.
In the past decades, many patients had to have their uterus removed in order to treat fibroids; in recent years, the vast majority of these patients can be treated with safe, non-scarring methods that do not remove the uterus.
Uterine fibroids, a very common disease, are present in almost every woman throughout her life, only, only a minority of patients cause symptoms, but, this minority is definitely not small. This disease could have been treated by puncturing a small 2 mm hole in the groin into the femoral artery, then sending a very thin catheter in, through multiple vessels into the uterine artery, then using an even thinner catheter through the catheter just now, into a branch of the uterine artery, then injecting an embolic agent from this very thin catheter to block the blood supply artery to the fibroid, thus cutting off the blood supply to the fibroid and putting the fibroid “starve” the fibroids to death. The fibroids will gradually shrink or fall off after the embolization, and will be discharged from the vagina after they fall off. After the operation, CT or ultrasound examination again, the uterus completely returns to normal shape.