59 - Uterine Artery Embolization: An Interventional Aid
Purpose: Fibroids are the commonest benign lesions of the uterus. It presents with bleeding per vagina in majority of the cases. Surgical treatment consists of hysterectomy or myomectomy with or without salpingo oophrectomy, with its inherent morbidity, prolonged hospital stay and psychosocial problems. Surgery is not the best option especially in nullipara women.
Material and Methods: 665 patients were subjected to uterine artery embolisation (UAE). Mean age was 33.71 ± 6.27 years. 38 patients were suffering from advanced carcinoma of cervix, 608 patients had fibroid of uterus, 19 patients had endometriosis. 57 patients were unmarried, 55 patients did not have any issue, 52 patients had associated haemodynamically significant cardiac disorders, 19 patients had polycystic renal disease, and 18 patients had hypernephroma. 76 patients had multiple fibroids. The UAE was done through contralateral femoral artery puncture, bilaterally, with the help of Robertson Uterine catheter. Ultrasound was repeated after 2 months.
Results: The UAE was successful in all patients. Mean procedural time was 66 minutes. Hospital stay was 1 day only. Bleeding stopped in all 665 patients. 20 patient had recurrence of bleeding after 2 months and underwent surgery. Fibroids disappeared in 152 patients, decreased in size by > 72% in 209 patients, and by 50-75% in 114 patients. 95 patients did not report back with ultrasound. 38 patients had normal delivery after UAE.
Conclusions: Uterine artery embolisation is effective therapy to stop uterine bleeding. It is effective in controlling the symptoms in uterine fibroids and also decreases the size of fibroids. Hospital stay is only 1 day.