UTERINE ARTERY EMBOLIZATION FOR THE TREATMENT OF UTERINE FIBROIDS

The first reported Gases of uterine artery embolization in obstetric a nd gynaecological practice were carried out in the late 1970s. Recentl y, bilateral uterine artery embolization was used as a primary treatme nt for fibroids. Meticulous pre-operative assessment is essential, The technique of uterine artery embolization involves the catheterization of both uterine arteries and the installation of tiny micro particles of polyvinyl alcohol. Following the procedure, post-procedural pain o ccurs within the first 24 h and most patients are advised to rest for 1 week. In the UCLA and RSCH series, three infective complications occ urred leading to hysterectomy and some patients developed amenorrhoea. Average shrinkage of fibroids in the UCLA, RSCH and French series wer e 40%, 64% and 70%, respectively, with most patients losing their symp toms and being satisfied with the procedure. Meticulous pre-operative assessment is essential. At ULCA, 140 patients, and at RSCH, 96 patien ts have been embolized. To date in the UK, US and French series, fibro id growth has been arrested and new fibroids have not formed. However, long-term follow-up on a larger number of cases will be required befo re the role of uterine artery embolization in the gynaecologic therape utic armamentarium can be fully defined. (C) 1998 Lippincott-Raven Pub lishers.