TREATMENT OF UTERINE FIBROIDS IN LYON
Non-surgical alternative to hysterectomy fortreatment desuterine fibroidssymptomatic, toLyons
What is uterine fibroid embolization?
Uterine fibroid embolization (UFE) is a minimally invasive, image-guided procedure withLyonsused fortreat uterine fibroidswhich can cause heavy menstrual bleeding, pain and pressure on the bladder or bowels.
The interventional radiologist, passing through the artery of the wrist, will guide a small catheter into the arteries of the uterus to deliver small embolization balls there. These beads block the arteries that supply blood to the fibroids and cause them to shrink.
Studies have shown with the highest level of scientific evidence that nearly 90 percent of women who receive UFE experience significant or complete resolution of their symptoms related tofibroids(1). This is just as much as by hysterectomy after 10 years of follow-up (2). Lembolization thus makes it possible to keep her uterusand D'avoid surgerywith a shorter recovery time and without scarring.
Embolization can also treatadenomyosisWhereinternal endometriosis, as well as bleeding from theuterusafter delivery (delivery hemorrhage).
PROCEDURE OF FIBROID EMBOLIZATION IN IMAGE
 Utérus en IRML'IRM sert à cartographier précisément les fibromes avant traitement et à planifier le traitement. Elle élimine aussi les diagnostics différentiels. |  Artère iliaque interneLe radiologue interventionnel cathétérise l'artère du bassin (artère iliaque interne) et repère la naissance de l'artère utérine. |  Embolisation gaucheLe cathèter est avancé dans l'artère utérine, et après avoir vérifier le bon postionnement et l'absence d'anastomose l'embolisation peu commencer! |
|---|---|---|
 Artère utérine droiteL'embolisation est réalisée en injectant de toutes petites billes qui vont obstruer les artères nourrissant les fibromes. L'embolisation est réalisée des deux cotés sur les deux artères de l'utérus. |  CicatriceA peine un point visible sur votre poignet |
Frequent_questions_cc781905-5cde-3194-bb3b-136bad5cf58d
I have symptomatic fibroids, how do I know if I am a candidate for embolization?
If your fibroids are responsible for an alteration in your quality of life, there is probably an indication for treatment.
This impact will be calculated by an adapted questionnaire before and after the treatment.
Next, imaging of the uterus should be performed so
- to confirm the diagnosis of uterine fibroids
- to precisely map their numbers, their sizes, their location on the uterus and their relationship to its walls.
- eliminate differential or associated diagnoses such as endometriosis, pelvic varices
This imaging is carried out by ultrasound then most often by a pelvic MRI.
MRI can also be used to map the uterine arteries in anticipation of embolization, saving time on the day of treatment.
If in doubt about a pathology of the endometrium, the gynecologist specialist can offer you a sample par hysteroscopy.
Depending on your symptoms and the position of the fibroids, your gynecologist will choose the most appropriate treatment. If there must be a physical treatment of fibroids, he will inform you of the surgical invasive possibilities. You can then also consult an interventional radiologist to be informed about the possibilities of minimally invasive treatments non-surgical such as uterine artery embolization (UAE)._cc781905-5cde -3194-bb3b-136bad5cf58d_
And after the operation, is it painful?
After embolization pain may occur linked to fibroid necrosis.
During the operation and for the duration of your hospitalization, you are looked after by an anesthetic doctor. The embolization is thus carried out under conscious sedation ensuring optimal comfort. Once in the room, the pain, if it exists, continues to be treated effectively thanks to a combination of pain and anti-inflammatory medication, including a morphine pump on demand.
This optimized pain management requires either a short hospitalization (1 to 2 nights) or the cooperation of nursing care at home.
Questions for your Interventional Radiologist (IR) -ASK4UFE
•How often is UAE successful in treating uterine fibroids?
• Are your patients satisfied with the procedure?
• How often do complications occur? What are the typical complications?
• How will I feel during and after the EAU treatment?
• How long should I expect to be off work?
• How long is the procedure ? What is the normal recovery time?
• How long should I expect to stay in the hospital?
• Is there care to be done afterwards and who manages it?
• What usually happens to fibroids after the blood supply is cut off?
Should I expect them to be expelled vaginally or the procedure
shrink my fibroids?
• Will my fibroids or the symptoms of my fibroids come back?
• Will I still get my period after having UAE and how will it be?
• Is WATER covered by social security and my mutual?
• Can you help me determine if I am a candidate for UAE and when can we
plan the procedure?
References:
3- Serres-Cousine O, Kuijper FM, Curis E, Atashroo D. Clinical investigation of fertility after uterine artery embolization. Am J Obstet Gynecol. 2021 Oct;225(4):403.e1-403.e22. doi: 10.1016/j.ajog.2021.05.033. Epub 2021 May 29. PMID: 34058169.
You want to know more?
Here are some useful links
mon-fibrome.fr: great multidisciplinary treatment decision support site for patients!
Poster summary of a survey of more than 1100 women with fibroids in the US.
A lot insufficiently informed woman!
Explicit video of Dr Amouyal (thank you!)
CONTACT US
