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Fibroid embolization

Chang-Woon Kim, Haeng Seon Shim, Hong Jang, Yun Gyu Song
OBJECTIVE: To evaluate the effects of UAE for symptomatic uterine fibroids on ovarian reserve based on AMH. STUDY DESIGN: This was a retrospective study conducted between March 2011 and October 2014. All women underwent UAE. At baseline and at the 3-month and 12-month follow-up visits, serum anti-Müllerian hormone (AMH), follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels were assessed, and ovarian volume and antral follicle count (AFC) were evaluated in each patient...
September 23, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
I E Porotikova, L V Adamyan, T Y Gavrilova, E A Kulabukhova
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
Maitri Raghavendra Kulkarni, Indranil Dutta, Dilip Kumar Dutta
BACKGROUND AND OBJECTIVES: Leiomyoma of uterus forms the most common type of benign tumor of uterus and also the most common pelvic tumor in women. The symptomatology continues to be variable. Surgery has for long been the main mode of therapy for the myomas. For women who wish to retain the uterus for future pregnancies or other reasons, myomectomy is preferred. Recent trend has been toward nonsurgical approaches like GnRH hormone analogs/agonists, RU 486, or selective uterine artery embolization, laparoscopic cryoablation, radiofrequency thermal ablation, and MRGUs...
October 2016: Journal of Obstetrics and Gynaecology of India
Nuri Peker, Savas Gundogan, Fatih Sendag
To present the feasibility of laparoscopic management of huge myoma nascendi DESIGN: Step by step explanation of the surgery using video SETTING: Uterine fibroids are the most common benign neoplasm of the female reproductive tract with the estimated incidence of 25-30% at reproductive age. Patients generally have no symptoms however patients those have symptoms such as severe pelvic pain, heavy uterine bleeding or infertility may undergo surgery. The traditional management is surgery however uterine artery embolization, hormonal therapy using GnRH (Gonadotropin-Releasing Hormone) agonists or SERM (Selective Estrogen Receptor Modulator) should be preferred as the medical approach...
September 12, 2016: Journal of Minimally Invasive Gynecology
Nuri Peker, Savaş Gundogan, Fatih Şendağ
To present the feasibility of laparoscopic management of huge cervical myoma DESIGN: Step by step explanation of the surgery using video SETTING: Uterine fibroids are the most common benign neoplasm of the female reproductive tract with the estimated incidence of 25-30% at reproductive age. Patients generally have no symptoms however patients those have symptoms such as severe pelvic pain, heavy uterine bleeding or infertility may undergo surgery. The traditional management is surgery however uterine artery embolization, hormonal therapy using GnRH (Gonadotropin-Releasing Hormone) agonists or SERM (Selective Estrogen Receptor Modulator) should be preferred as the medical approach...
September 12, 2016: Journal of Minimally Invasive Gynecology
Sangeeta Ramanan, Jude Chapman-Wardy, Roy Watson
A 43-year-old woman presented with severe anaemia secondary to menorrhagia. Pelvic ultrasound showed a large intramural posterior fundal fibroid. Hysteroscopy showed the fibroid distorting the endometrial cavity, precluding Mirena® device insertion. As she was initially hesitant to have a hysterectomy, medical management with the oral contraceptive pill (OCP) and tranexamic acid was instituted, with good effect. Months later, after a long road trip, she presented with left leg swelling, and a Doppler ultrasound confirmed an extensive deep vein thrombosis (DVT)...
2016: Case Reports in Obstetrics and Gynecology
Aska Toda, Kenjiro Sawada, Keigo Osuga, Noboru Maeda, Hiroki Higashihara, Tomoyuki Sasano, Noriyuki Tomiyama, Tadashi Kimura
AIM: The aim of this study was to retrospectively analyze the efficacies of uterine artery embolization (UAE) using gelatin sponge for symptomatic uterine fibroids. METHODS: A series of 60 consecutive premenopausal women underwent UAE using gelatin sponge particles or porous gelatin particles. Patients were routinely followed up at 1, 3, 6, and 12 months after the procedure and asked to report any procedure-related complications. At each follow-up, an original clinical questionnaire was completed by the patients to evaluate changes in fibroid-related symptoms...
2016: International Journal of Women's Health
James E Silberzweig, Daniel K Powell, Alan H Matsumoto, James B Spies
Uterine fibroids occur in approximately 50% of women over the age of 40 years, and an estimated 50% of those are symptomatic. Menorrhagia is the most common symptom and the primary indication for treatment, although bulk symptoms often occur and can be treated. Pharmacotherapy is typically inadequate unless it can be expected to successfully bridge to menopause or allow for a less-invasive intervention. However, hormonal therapies have risks. Hysterectomy is still the most commonly performed procedure for symptomatic fibroids and has the lowest rate of reintervention (compared with myomectomy or uterine artery embolization [UAE]), but rates of more serious complications are higher and patient satisfaction and ability to return to normal activities may also be less favorable...
September 2016: Radiology
Jacques Donnez, Marie-Madeleine Dolmans
Uterine fibroids (also known as leiomyomas or myomas) are the most common form of benign uterine tumors. Clinical presentations include abnormal bleeding, pelvic masses, pelvic pain, infertility, bulk symptoms and obstetric complications.Almost a third of women with leiomyomas will request treatment due to symptoms. Current management strategies mainly involve surgical interventions, but the choice of treatment is guided by patient's age and desire to preserve fertility or avoid 'radical' surgery such as hysterectomy...
July 27, 2016: Human Reproduction Update
Annefleur M de Bruijn, Willem M Ankum, Jim A Reekers, Erwin Birnie, Sanne M van der Kooij, Nicole A Volkers, Wouter J K Hehenkamp
BACKGROUND: Since 1995 uterine artery embolization has been described as an alternative for hysterectomy in patients with symptomatic fibroids. Many studies including several randomized controlled trials established uterine artery embolization as a valuable treatment. These randomized controlled trials reported outcomes in terms of health related quality of life, clinical outcomes, efficacy and cost effectiveness after 1, 2 and 5 years of follow-up. OBJECTIVE: The purpose of this study was to compare clinical outcome and health related quality of life 10-years after uterine artery embolization or hysterectomy in the treatment of heavy menstrual bleeding caused by uterine fibroids in a randomized controlled trial...
July 5, 2016: American Journal of Obstetrics and Gynecology
R Ruiz-Cruces, E Vano, F Carrera-Magariño, F Moreno-Rodriguez, M M Soler-Cantos, M Canis-Lopez, J Hernández-Armas, F J Diaz-Romero, F Rosales-Espizua, J M Fernandez-Soto, R Sanchez-Casanueva, A Martin-Palanca, M Perez-Martinez, A Gil-Agudo, M A Zarca-Diaz, V Parra-Osorio, J J Muñoz Ruiz-Canela, T Moreno-Sanchez, A Lopez-Medina, C Moreno-Saiz, P Galan-Montenegro, J J Gallego-Beuter, M Gonzalez-de-Garay, J C Zapata-Jimenez, J M Pastor-Vega, S Cañete
OBJECTIVES: To propose national diagnostic reference levels (DRLs) for interventional radiology and to evaluate the impact of the procedural complexity on patient doses. METHODS: Eight interventional radiology units from Spanish hospitals were involved in this project. The participants agreed to undergo common quality control procedures for X-ray systems. Kerma area product (KAP) was collected from a sample of 1,649 procedures. A consensus document established the criteria to evaluate the complexity of seven types of procedures...
July 6, 2016: European Radiology
Laurent Bédouet, Laurence Moine, Emeline Servais, Anne Beilvert, Denis Labarre, Alexandre Laurent
Uterine arteries embolization (UAE) is a recent technique that aims, by means of particles injected percutaneously, to stifle fibroids (leiomyomas). This treatment is non-invasive, compared with uterine ablation, but generates pelvic pain for a few days. A strategy to reduce the post-embolization pain would be to use calibrated embolization microspheres preloaded with a non-steroidal inflammatory drug (NSAID). In this study, we first compared four drugs, all active at low concentration on cyclooxygenase-2, i...
September 10, 2016: International Journal of Pharmaceutics
Gernot Rott, Frieder Boecker
BACKGROUND: Anatomic variants of the uterine artery are rare, with the absence of one of the uterine arteries presumably being the most abundant variant. A duplicated uterine artery is mentioned in the medical literature, but to the best of our knowledge, an angiographic study has never been published. A partially duplicated uterine artery is an extremely rare variant not previously mentioned in the literature, and it could lead to technical difficulties or cause problems in various gynecological interventions...
2016: Journal of Medical Case Reports
Ayman Shehata, Naglaa Hussein, Ahmed El Halwagy, Adel El Gergawy, Mohamed Khairallah
Uterine fibroids are benign tumors of the myometrium with a diverse range of manifestations. Fibroids can dramatically increase in size during pregnancy due to the increase in estrogen levels. After delivery, the fibroids usually shrink back to their pre-pregnancy size. Uterine myomas may have many complications, including abnormal uterine bleeding, infertility, pressure on nearby organs, degeneration, and malignant transformation. No previous reports have indicated that a fistula may develop between a uterine fibroid and the bowel loops, although previous studies have documented the occurrence of fistulas from the uterus to the bowel following myomectomy or uterine artery embolization performed to treat a myoma...
March 2016: Clinical and Experimental Reproductive Medicine
Juliana G Martins, Dawn Gaudenti, Frank Crespo, Dervi Ganesh, Usha Verma
Uterine leiomyomas are the most common benign tumors in young females and leading cause of hysterectomy. Uterine artery embolization is a safe option for women who wish to retain their uterus. Several complications have been reported including expulsion and sepsis. MRI is a useful pretreatment tool to predict results and outcomes. We report a case of a 44-year-old female with a history of uterine fibroids with the largest one being intracavitary. Patient underwent uterine artery embolization that was complicated by endomyometritis that failed antibiotics, leading to sepsis and hysterectomy...
2016: Case Reports in Obstetrics and Gynecology
Ahmed M AbdElmagied, Lisa E Vaughan, Amy L Weaver, Shannon K Laughlin-Tommaso, Gina K Hesley, David A Woodrum, Vanessa L Jacoby, Maureen P Kohi, Thomas M Price, Angel Nieves, Michael J Miller, Bijan J Borah, Krzysztof R Gorny, Phyllis C Leppert, Maureen A Lemens, Elizabeth A Stewart
BACKGROUND: Uterine fibroids are an important source of morbidity for reproductive-aged women. Despite an increasing number of alternatives, hysterectomies account for about 75% of all fibroid interventional treatments. Evidence is lacking to help women and their health care providers decide among alternatives to hysterectomy. Fibroid Interventions: Reducing Symptoms Today and Tomorrow (NCT00995878, is a randomized controlled trial to compare the safety, efficacy, and economics of 2 minimally invasive alternatives to hysterectomy: uterine artery embolization and magnetic resonance imaging-guided focused ultrasound surgery...
September 2016: American Journal of Obstetrics and Gynecology
Chika C Obele, Samantha Dunham, Genevieve Bennett, Johanna Pagan, Lok Yun Sung, Hearns W Charles
Background. Since its introduction in 1996, uterine fibroid embolization (UFE) has become standard medical practice in the management of symptomatic uterine fibroids. An extremely rare complication, pyomyoma, has been reported only 5 times previously in the literature following UFE. Case. A 37-year-old woman underwent UFE for symptomatic leiomyomas of the uterus. Signs and symptoms of uterine infection ensued, beginning at 6 days following the procedure. Recurrent fevers and increasing leukocytosis despite the intravenous administration of appropriate antibiotics eventually necessitated surgical intervention on postprocedure day #18...
2016: Case Reports in Obstetrics and Gynecology
Christopher A Enakpene, Toni Stern, Marco J Barzallo Salazar, Pradip Mukherjee
Background. Spontaneous rupture of an ovarian artery aneurysm is a rare but usually life-threatening event. It is most often associated with pregnancy or fibroids. Our case followed a normal vaginal delivery and then a delayed presentation with features similar to other less life-threatening postpartum conditions. The diagnosis could have been missed but for the meticulous and timely interventions which avoided catastrophic outcome. Case. This is a case of a multiparous woman with rupture of a left ovarian artery aneurysm, causing massive retroperitoneal hemorrhage and hematoma that required a combination of arterial embolization, percutaneous CT scan guided drainage, and surgical evacuation of the hematoma...
2016: Case Reports in Obstetrics and Gynecology
Derek M Biederman, Brett Marinelli, Paul J O'Connor, Joseph J Titano, Rahul S Patel, Edward Kim, Nora E Tabori, Francis S Nowakowski, Robert A Lookstein, Aaron M Fischman
PURPOSE: Transradial access (TRA) has been shown to lower morbidity and bleeding complications compared to transfemoral access in percutaneous coronary interventions. Morbid obesity, commonly defined as a body mass index (BMI) ≥40 kg/m2, has been shown to be a risk factor for access site complications irrespective of access site. This study evaluates the safety and feasibility of performing visceral endovascular interventions in morbidly obese patients via TRA. METHODS: Procedural details, technical success, and 30-day major and minor access site, bleeding, and neurological adverse events were prospectively recorded in a database of 1057 procedures performed via the radial artery...
May 7, 2016: Journal of Vascular Access
Keigo Osuga, Yasuo Nakajima, Miyuki Sone, Yasuaki Arai, Yoshihiro Nambu, Shinichi Hori
PURPOSE: To evaluate the feasibility and safety of transarterial embolization (TAE) using trisacryl gelatin microspheres (TGMs) for hypervascular tumors. MATERIALS AND METHODS: This was a prospective multicenter clinical trial involving five institutions. TAE using TGMs was performed for hypervascular tumors in various locations. The primary endpoint was the technical success. The secondary endpoints included catheter accessibility, preservation of the feeding arteries, local tumor response based on the Response Evaluation Criteria in Cancer of the Liver (RECICL) and adverse events related to TAE based on the Common Terminology Criteria for Adverse Events, version 4...
May 2016: Japanese Journal of Radiology
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