pregnancy information

Wednesday, 12 June 2013

Uterine fibroids

Uterine fibroids

Levonorgestrel intrauterine devices are highly effective in limiting menstrual blood flow and improving other symptoms. Side effects are typically very moderate because the levonorgestrel (a progestin) is released in low concentration locally. There is now substantial evidence that Levongestrel-IUDs provide good relief of symptoms in women with fibroids.

Uterine fibroids can be removed and the uterus reconstructed in a procedure called "myomectomy." This surgery may be performed through an open incision, laparoscopic or through the vagina (hysteroscopy).

Uterine artery embolization (UAE) is a minimally invasive procedure for the treatment of uterine fibroids. Under local anesthesia a catheter is inserted into the femoral artery in the groin and advanced under radiographic control in the uterine arterty. A mass of microspheres or polyvinyl material alcohol (PVA) (a plunger) is injected into the uterine arteries in order to block the flow of blood through the vessels. The restriction in blood supply usually results in a significant reduction of fibroids and improvement of heavy bleeding tendency. The 2012 Cochrane review comparing hysterectomy and UAE found no significant advantage for either procedure. While UAE is associated with a shorter hospital stay and faster return to normal daily activities was also associated with an increased risk of minor complications later. There was no difference between UAE and hysterectomy with respect to major complications.

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