Assuntos
Eletrocoagulação/métodos , Fármacos para a Fertilidade Feminina/administração & dosagem , Leuprolida/administração & dosagem , Dor Pós-Operatória/prevenção & controle , Útero/irrigação sanguínea , Útero/efeitos dos fármacos , Feminino , Hormônio Liberador de Gonadotropina , Humanos , Leiomioma/diagnóstico , Leiomioma/cirurgia , Medição da Dor , Cuidados Pré-Operatórios , Valores de Referência , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/cirurgiaRESUMO
STUDY OBJECTIVE: To analyze initial experience with uterine artery embolization for treatment of symptomatic leiomyomata. DESIGN: Prospective, longitudinal study (Canadian Task Force classification II-2). SETTING: Private practice, university-affiliated hospital. PATIENTS: Three hundred five women (age 26-52 yrs). INTERVENTIONS: Uterine artery embolization, performed over 2 years by a single radiologist working in collaboration with a single gynecology practice. MEASUREMENTS AND MAIN RESULTS: Embolization was technically successful in 96% of patients. No major complications occurred. Average reduction in uterine volume was 48%. Control of menorrhagia was reported by 86% of patients at 3 months, 85% at 6 months, and 92% at 12 months after the procedure. Bulk symptoms were satisfactorily controlled in 64% of patients at 3 months, 77% at 6 months, and 92% at 12 months. Six women subsequently underwent hysterectomy and five had myomectomy. CONCLUSION: Uterine artery embolization appears to be a highly effective treatment for symptomatic uterine leiomyomata. Its impact on fertility and pregnancy remain to be investigated fully. (J Am Assoc Gynecol Laparosc 6(3):279-284, 1999)
Assuntos
Embolização Terapêutica/métodos , Leiomioma/cirurgia , Neoplasias Uterinas/cirurgia , Útero/irrigação sanguínea , Adulto , Endossonografia , Feminino , Seguimentos , Humanos , Leiomioma/diagnóstico por imagem , Leiomioma/fisiopatologia , Estudos Longitudinais , Pessoa de Meia-Idade , Gravidez , Estudos Prospectivos , Resultado do Tratamento , Neoplasias Uterinas/diagnóstico por imagem , Neoplasias Uterinas/fisiopatologiaRESUMO
BACKGROUND: Since October 1996, at our fibroid center, we have been using the uterine artery embolization (UAE) procedure as a nonsurgical means to treat patients with fibroids and menorrhagia. We have performed this procedure on over 180 patients, 3 of whom experienced vaginal expulsion of submucosal fibroids from two to seven months later. CASES: A 37-year-old woman underwent UAE in November 1997 and expelled five submucosal fibroids two to three months later. A 43-year-old woman underwent UAE in August 1997 and expelled a submucosal fibroid four months later. A 46-year-old woman underwent UAE in April 1997 and expelled a submucosal fibroid seven months later. CONCLUSION: The use of UAE to treat patients with fibroids and menorrhagia is relatively new. Our experience has revealed that a significant percentage of patients who have had the embolization procedure will have reduction in menorrhagia and also in the volume of their fibroids. Complications and side effects have been few. Vaginal expulsion of submucosal fibroids can be viewed as a side effect of the procedure, and, to the best of our knowledge, these are the first reported cases of this postembolization occurrence.
