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uterus fibroid

What is uterine / uterus fibroid?

Uterine fibroids (myomas, leiomyomas, or fibromyomas) are the most frequent tumour of the female genital tract: 20 to 40% of women of childbearing age have a fibroid.

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Types of Uterine Fibroids

Adenomyosis may be mild and cause no symptoms at all, Though adenomyosis is considered a benign (not life-threatening) condition, it can have a negative impact on a woman’s quality of life. The common symptoms are: –

  • Intramural fibroids are located within the wall of the uterus and are the most common type.
  • Sub-serosal fibroids are located on surface of the uterus and can become very large. They can cause pressure over bladder and rectum producing urgent urination and constipation with back pain.
  • Submucosal fibroids are located in the cavity of uterus; even small lesion in this location may lead to excessive bleeding and infertility.
  • Cervical fibroids are located in the wall of the cervix (neck of the uterus). They may block/narrow the passage causing difficulty in delivery.

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Symptoms of Fibroid :-

  • Heavy, prolonged menstrual periods with clots. This might lead to anaemia.
  • Lower abdomen, back or leg pain
  • Lower abdomen pressure or heaviness
  • Bladder pressure leading to a constant urge to urinate
  • Pressure on bowel, leading to constipation and bloating
  • Abnormally enlarged abdomen

Diagnosis :-

  • Diagnosed during examination or during health check-up.
  • Confirmed by a lower abdomen or transvaginal ultrasound.
  • Better evaluated by MRI scan
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Non-surgical treatment options for uterine fibroids :-

Uterine artery embolization / Uterine Fibroid embolization

It is a minimally invasive interventional radiological procedure, which means it requires only a tiny nick in the skin. It is performed under sedation – feeling no pain and usually requires a hospital stay of one night. Many women resume light activities within a day or two.

Ideal Patient for uterine artery embolization:-

  • They have single / multiple fibroids
  • The fibroids are symptomatic or big size
  • Fibroids associated with adenomyosis.

UFE treats all uterine fibroids at the same time and is, therefore, extremely effective.

uterus fibroid

A tiny angiographic catheter is inserted through a nick in the skin in to an artery and advanced into fibroids. Tiny polyvinyl alcohol particles are wedge in the small arteries to blocking the blood flow to the fibroids.

While embolization to treat uterine fibroids has been performed since 1995, embolization of the uterine artery is not new. It has been used successfully by interventional radiologist for over 20 years to treat heavy bleeding after childbirth (PPH).

Advantages of Uterine artery embolization :-

  • It is performed short anaesthesia.
  • Requires only a tiny nick in the skin (No surgical incision of abdomen).
  • Recovery is very short compares to that from hysterectomy or open myomectomy.
  • Virtually no adhesion formation has been found. But in surgery adhesions are common.
  • All fibroids are treated at once, which is not the case with myomectomy.
  • Recurrent growth of treated fibroids is uncommon.
  • Uterine fibroid embolization involves virtually no blood loss or risk of blood transfusion.
  • If the presenting complaint was excess vaginal bleeding, 87-90% of cases experiences resolution within 24 hours.
  • Emotionally, financially and physically – embolization can have an overall advantage over other procedures for the patient as the uterus is not removed.

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Uterine Artery Embolization is useful in many conditions :-

  • Single / multiple Uterine Fibroids.
  • Adenomyosis.
  • Failed myomectomy / recurrence of fibroids after myomectomy
  • High risk patient for surgery like obesity, anaemia, Chronic renal failure etc.
  • Post-partum Haemorrhage bleeding during and after birth of baby.
  • Bleeding from Cancer of Cervix & Uterus
  • Pre-operative embolization to reduce bleeding during uterine surgery.
Dr. Pradeep Muley

Dr. Pradeep Muley M.D.

Senior Consultant Interventional Radiologist

Fortis, Vasant Kunj, New Delhi, India

Date of Birth : September 27, 1963

Nationality : Indian

Contact : +91-9810492778

Email : muleypradeep@hotmail.com

Academic Qualifications :-

  • Fellow Interventional Radiology. Singapore General Hospital, Singapore
  • Visiting Associate, Neurointerventional Radiology, Iowa University Hospitals, USA
  • Visiting Fellow, Neurointerventional Radiology, Johns Hopkins Medical Institutions, USA
  • Lecturer, Vascular & Interventional Radiology, KEM Hospital, Mumbai, India
  • Neuroradiology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
  • Consultant Interventional Radiologist, KIMS hospital, Trivandrum, Kerala, India

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