Centers of Excellence in Interventional Cardiology and Radiology

Uterin Fibroid

Uterine fibroid embolization

Dr. Rares Nechifor is the most famous radiologist in Romania!

So far he has treated more than 10.000 cases of uterine fibroid.

We are the only East European Center for Training and Excellence in Uterin Fibroid Therapy

The simplest method of treating the uterine fibroid

Only 24 hours hospitalization

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Generalities

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Uterin fibroid is a benign tumor (non-cancerous tumor) wich develops from the muscular layer of uterin wall. The size and the number of uterine fibroids have a high variability: in most of cases there are 1-3 fibroids that can be seen in ultrasounds imaging, whom dimension are between 10-200 mm and a lot of others small node ( only a few mm) wich can’t be seen in ecocardiography.

Uterine embolization is a new non-surgical method, for the treatment of uterine fibroids, that consists in closure of the vessel that are supplying these fibroids ( uterine arteries). Secondary, the fibroids suffer a process of resorption, the uterus comes back to his initial dimension and the symptoms disappear.

Indications

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Symptoms have a high variability, depending on size, number and location of fibroids. So, patients may present:

  • pelvic pain ( related with menstrual bleeding, cold, but also sexual contact)
  • swelling of the abdomen
  • back pain
  • frequent urination ( because of compression urinary bladder)
  • constipation and flatulence
  • infertility, spontan abortion
  • heavy menstrual bleeding ( sometimes with clots)
  • prolonged menstrual periods, bleeding between periods
  • anaemia

Procedure

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Uterin fibroids embolization, also know as uterin artery embolization, is performed in our Center of Excellence, in the catheterism labs, under local anesthesia, respecting the asepsy rules. You will receive aslo heparin iv (a drug wich prevents clots).

Your doctor will tell you to lie down on angiography table; the asistent will clean your elbow area with iodine substance, then a sterile field will cover this area. After local anesthesia (with xilin), your doctor puncture the brahial artery and then inserts a sheath into the artery (a small, plastic device having only 4 mm diameter). Then, a catheter (a tiny plastic tube) is advanced into this sheath , using constrast dye substnace and fluoroscopic guidance, so the catheter will be advanced through the right uterine artery. At this point, specials, biocompatibles particles are released and the uterines arteries are occluded. All this time, patient is awake, but she doesn’t feel any pain. The procedure is made for both uterine arteries, left and right. This blocks the blood flow to the fibroid tumor and causes it to shrink and die. When the procedure is done, the sheath is removed, and the asistent will press the puncture place for 10 minutes, in main to obtain hemostasis, and after will make a compressive dressing, wich will be removed the next day.

Is it painful?

The doctor may use local anesthesia, using xilin, wich may induced local warmth for 10-20 seconds. You will not feel any pain associated with all puncture manoeuvres. Also, when the contrast material is injected for very short time (about 5 second) you feel will local warmth, in your abdomen.

Uterin arteries embolization can be associated with pain after the procedure is done ( after several hours), but every patient has her own degree of pain. Because of this, you will received pain drugs before the procedure starts.

It’s important to understand that pain after the uterine arteries embolization is absolutely normal and it can last several hours, but your doctor will prescribe you pain .

How long does it take?

The average duration of this procedure is about 30 minutes and is performed in the cath lab. All this time the patient remains lie down on the table; it’s important that the stays relaxed – otherwise back pain (related with the position during the procedure) can appear.

Risks

Uterine artery embolization is a safe, minimally invasive procedure, but not completely without risks.

The most frequent complication is pain after embolization – as we pointed above, pain it’s perfectly normal and can be treat with drugs pain.

Another complication is a little hematoma at the vascular puncture site – doesn’t need a specific treatment, but ice can be placed at this level. In case of a big hematoma, atibiotics are needed, and, in some cases even his evacuation.

Fever after procedure is another complication and is related with the ischemic process of the fibroids – pain drugs are also efficient in treatment of fever. But if fever appears after several days it may indicate an uterine infection, so your doctor must be notified about this.

You should also know that bleedings are still possible weeks after the procedure, sometimes smallsfibroids fragments may be identified.

Before procedure

Hospitalization for 24 hours is required. You will be asked to fast for eight hours before the procedure, generally after midnight.

Your doctor will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure. You will be asked to sign a consent form that gives permission to do the procedure.

Notify your doctor if you are sensitive to or are allergic to any medications, latex, iodine, tape, contrast dyes, and anesthetic agents (local or general). Notify your doctor of all contrast imaging.

After procedure

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You will be conducted to your room and connected to monitors that will constantly display your electrocardiogram (ECG or EKG) tracing, blood pressure, other pressure readings, breathing rate, and your oxygen level. You will be given pain medication .

You dont’t need to lie down, but is recommended that you don’t move your arm for 4 hours.

You should also drink a lot of fluids.

DOCTORS
that perform the procedure

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Sună Mesaj