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1). Uterine Artery Embolization

What it is – It is a non- surgical treatment for utrine fibroid called Uterine Artery Embolization. It is done without any scar in abdomen and it need just mild sedation. No risk of blood loss or blood transfusion. It can be done in women who: -  

  • Experience symptoms of uterine fibroids.
  • A desire to retain her uterus and wants hysterectomy alternatives.
  • Does not desire surgery.
  • Poor surgical candidate (e.g., because of obesity, bleeding disorders, anemia).
  • Is not pregnant at the time of procedure.

How it is done - "Uterine fibroid embolization is a non-invasive, non-surgical outpatient procedure. This procedure blocks the blood supply of the arteries that supply fibroids causing them to shrink. Embolization uses angiographic techniques to place a catheter into the uterine arteries so that PVA particles can be injected through catheter and into the blood supply of the fibroids.

Conditions which can be treated –

  • Single / multiple Uterine Fibroids. 
  • Adenomyosis. 
  • Failed myomectomy / recurrence of fibroids after myomectomy 
  • High risk patient for surgery like obesity, anemia, chronic renal failure etc. 
  • Post-partum Hemorrhage 
  • Bleeding from Cancer of Cervix & Uterus 
  • Pre-operative embolization to reduce bleeding during uterine surgery.

Side effects – Negligible
About 1% chances of infection and is typically characterized by fever and smell from vagina. It needs antibiotics and it subside in 99% of women.
Mild pelvic pain will remain for 1-2 days it is controlled very well by simple pain medication.

Mild fever is also expected. It is well controlled by paracetamol oral tablets.
About half a percentage of the woman land-up in temporary short term menopause. Later they may resume normal periods. 

Advantages Non-surgical treatment– it shows overall success rate of about 96-98% which is unlikely in any other method of treating fibroids.

  • It is the only method that can treat the multiple fibroids in one sitting.
  • The uterine artery embolization treats the fibroids and adenomyosis together in one procedure.
  • No surgical scar or blood loss during the procedure.
  • It needs just day care or 24 hrs hospitalization.
  • Short recovery time may be just one day.

Focused ultrasound surgery: - MRI-guided focused ultrasound surgery (FUS) is a noninvasive treatment option for uterine fibroids that preserves your uterus. This procedure is performed while you're inside of a specially crafted MRI scanner that allows doctors to visualize your anatomy, and then locate and destroy (ablate) fibroids inside your uterus without making an incision. Focused high-frequency, high-energy sound waves are used to target and destroy the fibroids. One or two treatment sessions are done in an on and off fashion, sometimes spanning several hours. Because it's a newer technology, researchers are learning more about the long-term safety and effectiveness of FUS. Research continues, but so far data collected show that FUS for uterine fibroids is safe and very effective.

Which is best treatment option