{"id":1794,"date":"2024-03-11T21:21:43","date_gmt":"2024-03-11T21:21:43","guid":{"rendered":"https:\/\/blog.antoniolamarca.it\/?p=1794"},"modified":"2024-03-12T08:34:50","modified_gmt":"2024-03-12T08:34:50","slug":"sperm-quality-decreases-with-lethality-2-2-2","status":"publish","type":"post","link":"https:\/\/blog.antoniolamarca.it\/en\/sperm-quality-decreases-with-lethality-2-2-2\/","title":{"rendered":"EMBOLISATION OF UTERINE FIBROIDS"},"content":{"rendered":"Reading Time: <\/span> 3<\/span> minutes<\/span><\/span>
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Uterine artery embolisation for the treatment of symptomatic uterine fibroids is a<\/div>\n
minimally invasive procedure first described in 1994, then performed increasingly<\/div>\n
often in many Western countries. The method is characterised by a high success rate<\/div>\n
85%, capable of providing significant relief in women and characterised by<\/div>\n
a low complication rate. Uterine fibroids, the most common type of benign tumour among women in<\/div>\n
reproductive age, are associated with heavy menstrual bleeding, abdominal discomfort,<\/div>\n
subfertility and a reduced quality of life. Not all women are willing to undergo<\/div>\n
uterine removal surgery, current guidelines on the clinical management of ACOG<\/div>\n
support the technique of uterine embolisation, which is therefore an answer for<\/div>\n
those women who wish to preserve their uterus or who have not benefited from the<\/div>\n
medical care.<\/div>\n
As with any procedure, careful patient selection is crucial. Ideal candidates<\/div>\n
for uterine artery embolisation include patients with symptomatic fibroids who wish to<\/div>\n
preserve the uterus and\/or avoid surgery. Symptoms of uterine fibroids may include<\/div>\n
menorrhagia and\/or metrorrhagia; pelvic mass symptoms manifesting as pelvic pain,<\/div>\n
sense of weight or bloating, dyspareunia, severe cramps or urinary disorders. Absolute contraindications<\/div>\n
include pregnancy, untreated active endometritis and suspected malignancy, unless<\/div>\n
are not treated for palliative purposes or in addition to surgery, fibroma of less than 1 cm or fibroma<\/div>\n
with pedunculated morphology, fibroma localised in the cervix. Allergy to contrast medium, the<\/div>\n
coagulopathy, desire for future fertility and renal insufficiency are relative contraindications.<\/div>\n
Appropriate counselling should be carried out for the potential risks associated with the technique,<\/div>\n
including bleeding, infection, renal damage due to contrast administration<\/div>\n
intravascular, impact on fertility and possibility of requiring surgery.<\/div>\n
The technique consists of injecting small particles, such as tris-acrylic gelatin spheres (TAG),<\/div>\n
non-spherical polyvinyl alcohol (PVA) and spherical PVA, in uterine arteries after selective catheterisation,<\/div>\n
entry into the arterial system is usually achieved by unilateral or bilateral access<\/div>\n
to the common femoral artery. For the procedure, anaesthesia in<\/div>\n
sedation.<\/div>\n
The expected results after uterine artery embolisation are excellent, the SIR guidelines indicate<\/div>\n
that approximately 90% of women should experience a reduction in general symptoms and that more<\/div>\n
of 90% should expect the elimination of abnormal uterine bleeding, a reduction of<\/div>\n
50-60% of fibroid size and a 40-50% reduction in uterine size. For the<\/div>\n
women with ideal procedure selection characteristics, it is possible to achieve a high rate<\/div>\n
of symptom control, a satisfaction rate and an increase in the quality of life rate of up to<\/div>\n
to 10 years after the procedure. Causes of failure include poor patient selection,<\/div>\n
large fibroids, inability to catheterise uterine arteries or embolisation<\/div>\n
incomplete artery, arterial spasm leading to poor flow of the embolic artery,<\/div>\n
anatomical variants of the uterus or the recanalisation of embolised arteries.<\/div>\n
Healthy pregnancies have been reported sporadically following embolisation of the artery<\/div>\n
uterine, but the actual fertility rate after the procedure remains uncertain. In contrast, the low<\/div>\n
at birth, miscarriage and prematurity have been associated with the technique. Despite the risks<\/div>\n
inherent of possible fertility problems, the procedure remains an option for women with fibroids<\/div>\n
clinically symptomatic people who wish to become pregnant. However, further<\/div>\n
research on conception rates and obstetrical risks of infertility.<\/div>\n
\u200b<\/div>\n
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References<\/div>\n
Jonathan J Keung, Uterine artery embolization: A review of current concepts. Best Pract Res Clin<\/div>\n
Obstet Gynaecol. 2018 Jan:46:66-73. doi: 10.1016\/j.bpobgyn.2017.09.003. Epub 2017 Sep 29.<\/div>\n
Michael Young, et al. Uterine Fibroid Embolization. Treasure Island (FL): StatPearls Publishing; 2024<\/div>\n
Jan 2023 Jul 3.<\/div>\n
Parker E Ludwig, et al. Pregnancy success and outcomes after uterine fibroid embolisation: updated<\/div>\n
review of published literature.<\/div>\n
Br J Radiol. 2020 Jan;93(1105):20190551. doi: 10.1259\/bjr.20190551.<\/div>\n
Epub 2019 Oct 8.<\/div>\n<\/div>\n<\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"

Reading Time: <\/span> 3<\/span> minutes<\/span><\/span> L\u2019embolizzazione dell\u2019arteria uterina per il trattamento dei fibromi uterini sintomatici \u00e8 una procedura minimamente invasiva descritta per la prima volta nel 1994, eseguita poi sempre pi\u00f9 spesso in molti paesi occidentali. Il metodo \u00e8 caratterizzato da un’elevata percentuale di successo tecnico pari a circa l’85%, in grado di dare un sollievo significativo nelle donne e …<\/p>","protected":false},"author":1,"featured_media":1801,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"single-classic-ns.php","format":"standard","meta":{"om_disable_all_campaigns":false,"footnotes":""},"categories":[5,2],"tags":[],"class_list":["post-1794","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-featured","category-press"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/blog.antoniolamarca.it\/en\/wp-json\/wp\/v2\/posts\/1794","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blog.antoniolamarca.it\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.antoniolamarca.it\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.antoniolamarca.it\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.antoniolamarca.it\/en\/wp-json\/wp\/v2\/comments?post=1794"}],"version-history":[{"count":2,"href":"https:\/\/blog.antoniolamarca.it\/en\/wp-json\/wp\/v2\/posts\/1794\/revisions"}],"predecessor-version":[{"id":1803,"href":"https:\/\/blog.antoniolamarca.it\/en\/wp-json\/wp\/v2\/posts\/1794\/revisions\/1803"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blog.antoniolamarca.it\/en\/wp-json\/wp\/v2\/media\/1801"}],"wp:attachment":[{"href":"https:\/\/blog.antoniolamarca.it\/en\/wp-json\/wp\/v2\/media?parent=1794"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.antoniolamarca.it\/en\/wp-json\/wp\/v2\/categories?post=1794"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.antoniolamarca.it\/en\/wp-json\/wp\/v2\/tags?post=1794"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}