ROLE OF TRANS-CATHETER EMBOLIZTAION OF UTERINE ARTERY IN UTERINE BLEEDING

Abstract

Background: Abnormal uterine bleeding in terms of menstrual disorders and postmenopausal bleeding are common clinical problems in both primary and secondary care. Advances in diagnostic and therapeutic technologies have offered opportunities to improve the outcomes of women suffering with these complaints. Interventional radiology is a relatively new, exciting and rapidly evolving subspecialty of radiology in which both vascular and non-vascular diseases are treated by minimally invasive approaches. Uterine-artery embolization was introduced as an alternative technique for treating cases with vaginal bleeding . Since then it has become increasingly accepted as a minimally invasive, uterine-sparing procedure Aim of the work: The aim of this work is to evaluate role of trans-arterial embolization of uterine artery in uterine bleeding . Patients and methods: The study was carried out on twenty patients suffering from uterine bleeding for different causes. Those patient undergoes pelic us ( trans abdominal & trans vaginal ) , Doppler Us exam & in some cases MRI to determine cause of abnormal uterine bleeding before the embolization. Then after embolization those patient had been followed up for 6 months with pelvic UD & Doppler . In 7 patient interstitial fibroids was diagnosed as the cause of the abnormal uterine bleeding . other 6 patient uterine AVM ( all of them after gynecological procedure ) was the cause. In the rest ( 7 patient ) no specific lesion was diagnosed by US or MRI only increased vascularity of the uterus was detected by the Doppler exam. Results: The most common presenting symptoms of the patients abnormal bleeding, were anemia, low back pain, had frequency of micturition and dyspareunia .All our 20 patient had marked improvement – most shows disappearance of symptoms - after the procedure. All severs from post embolization syndrome ( nausea, vomiting & abdominal pain ).No major complication had occurred for any of our patient. Conclusion: UAE is the best treatment for abnormal uterine bleeding that not only stop the bleeding but also preserve uterus & can keep the patient fertile for further conception. UAE is save & has no major complication , however , it’s a high coast technique.
Keywords: uterine bleeding , Fibroids , embolization.