Many women, suffering from uterine fibroids, as a method of treatment are recommended hysterectomy - the removal of the uterus. At the same time there is often nothing said about rather negative long-term consequences of that surgery. Meanwhile, for over the past several decades, in developed countries is widely used an effective, minimally invasive , organ preserving and safe alternative for the treatment of the uterine fibroids, which is a reliable method of the modern evidence-based medicine – uterine artery embolization (UAE).
The essence of UAE (uterine artery embolization) is in cessation of blood flow along the branches of uterine arteries, supplying the blood to the uterine fibroids. At the same time branches, supplying a healthy part of myometrium, do not suffer. It is possible due to the peculiarities of the blood flow in the myoma: blood supply of the nodes is implemented from the so called peri-fibroid plexus – vasculature, surrounding myoma around the periphery. These vessels have a diameter of up to 0,5 mm, i.e. several times more , than arteries of normal myometrium. After introducing into these vessels the special embolization particles, myoma loses blood supply, and the replacement by a connective tissue occurs - fibrosis, that leads to a significant decrease and/or disappearance of uterine fibroids and its manifestations.
In MC Erebouni has already more than 2 years used UAE (uterine artery embolization).
The results are quite impressive. For the last 2 weeks in 3 patients the uterine artery embolizations procedures have been performed.
The first patient – a woman S.A., 47 y/o, has admitted to MC Erebouni in 22.04.17 with diagnosis of multiple uterine fibroids, uterine bleeding, autoimmune hepatitis, and coagulopathy. The size of the uterus was : 136 ×111 × 112 mm; the largest myomatous node with an interstitial position was of 73 × 80mm.
The second patient – a young woman B.D., 35 y/o, in 29.04.17 has admitted to MC Erebouni with recurrence of uterine fibroids and uterine bleeding. The ultrasound of pelvic organs revealed: the size of the uterus was: 107 × 49 × 69mm; 2 myomatous nodes with a size of 74 × 64 and 42×31mm are defined .
In 2011 she underwent conservative myomectomy (when the myomectomy is performed, there is a possibility (almost in 30% of cases!), that myomatous nodes may reoccur).
The third case - is an Armenian patient from Greece, S.I., 46 y/o. Multiple uterine fibroid was detected in the patient. The size of the uterus was 160×101×162mm, and was deformed due to multiple myomatous nodes, the largest of which was 67 × 70mm.
Having read on our website www.erebunimed.com the information about the endovascular surgeries performing in our clinic and successful results of uterine artery embolization, the patient decided to apply to the specialists of MC Erebouni.
All patients, before coming to MC Erebouni, had been recommended hysterectomy (the removal of the uterus) – as a method of treatment. However, in our clinic the problem was resolved by the uterine artery embolization by endovascular surgeon of Angiography Department of MC Erebouni Dr. A. Tsaturyan, and the patients were discharged on the 4-5th day in a satisfactory condition.
Regression of symptoms, associated with fibroids (compression, bleeding, frequent urination, bloating, back pains), the patients feel already on the second day after the surgery. The first manifestations of the effectiveness of UAE (uterine artery embolization) are the normalization of the symptoms: myomatous nodes are decreased, menstrual bleeding normalizes, it volume and duration reduces, the symptoms of compression are also reduced. The reduction in uterine size the most actively takes place during the first 6-8 months after UAE. Myomatous nodes aren`t removed in case of uterine artery embolization. Embolization particles cover the vessels and myoma as if “dries out”, like the grape, becoming “raisin”. The small and medium size uterine fibroids totally disappear.
After a hysterectomy there is no any options for childbearing. Even after myomectomy often arises infertility, associated with formation of adhesions in the uterus and around it. An important advantage of myomatous nodes embolization is that it doesn`t deprive women of childbearing capacity.
In recent years UAE (uterine artery embolization) has so firmly established in medical practice, that it is safe to say, that uterine artery embolization - is a radical, effective and organ preserving method of the treatment of uterine fibroids. Positive results in short- and long-term follow-up of large number of the patients ( more than 98% women) show, that after UAE they don`t need any additional treatment for uterine fibroids, at the same time preserving the reproductive function.
