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Hope For Fibroids Poster (PDF)

To download Adobe Reader
 

UTERINE MYOMA EMBOLISATION FACING THE NEW MILLENIUM

The Department of Interventional Radiology and Endovascular Treatment, is pioneer in the country and the world in the uterine myomas embolisation, a new technique that treats this disease without need of surgery, making the first case in 1995.  This procedure is made by a team of professionals highly specialized in this type of treatments. 

Dr. Ricardo García Mónaco in the Argentine Ambito Financiero Newspaper, Health Section (photo below).

Next we offer some explanations in order to make your decision easier.   

A .pdf document which is one of Dr. Garcia Monaco latest publications in Spanish, "Embolizacion de miomas uterinos"; Ricardo D. Garcia Monaco, Roberto Testa; 2006

“Between 20 and 40% of women over 35 have fibroids "

What are miomas (uterine fibroids)?

Fibroids or uterine leiomyomas are benign, non­-cancerous growths inside the uterus or in its muscular wall.  Fibroids can vary enormously in size, from that of a pea to that of a melon.  Multiple growths may be present at the same time, anywhere in the uterus.  They are classified according to their location:

Intramural fibroids – develop in the uterine wall.

Subserosal fibroids – develop in the abdomen outside the uterus.

Submucosal fibroids – develop inside the uterine cavity.

What are the symptoms?

Symptoms vary but the most common are:

- regular, heavy menstrual bleeding
- pain in the pelvic area
- heaviness, cramps and swelling of the abdomen
- pain during urination or bowel movement
- infertility

How are they diagnosed?

Such symptoms do not necessarily mean that fibroids are present, which can only be confirmed by pelvic examination, possibly including an ultrasound scan or a magnetic resonance imaging (MRI) examination.

How are Fibroids treated?

Most fibroids are asymptomatic and do not cause any particular problem.  If this is the case, treatment is unnecessary.

Three Types of Treatments

Drugs: anti-haemorrhagics or anti-inflammatories can be used to treat the patient's symptoms. Certain hormones can also be beneficial. However, the efficacy of drugs and hormones is usually limited and their effects temporary.  Moreover, side effects may limit the duration of the course of treatment.

Surgical removal: various surgical techniques can be used, depending on the size, number and location of the fibroids:

- myomectomy involves the individual removal of each leiomyoma.  Different approaches can be used, including coelioscopy, hysteroscopy or abdominal incision, but all entail a hospital stay of several days followed by a one to six week convalescence period.  Myomectomy can complicate subsequent pregnancies because it causes scarring of the uterine muscle tissue.

- hysterectomy involves the removal of the entire uterus by coelioscopy or surgery (either abdominal surgery or via a vaginal approach). This treatment modality definitively eliminates the fibroids but both hospital stay and convalescence period are long.  And of course, hysterectomy abolishes the possibility of later pregnancy.

"Embolisation -which preserves the uterus- is an alternative to surqical  removal"

Embolisation: an alternative to surgery which preserves the uterus, since the development of this technique in France in the early 1990's, about 40,000 women have been treated across the world. Embolisation results in shrinkage of the fibroids by blocking their blood supply. This procedure attenuates or abolishes symptoms (pain, bleeding, urination problems, etc.) in 90% of subjects. Embolisation is performed with mild local anaesthesia and involves a hospital stay of under 48 hours.

Post­operative pain is managed with various drugs or by means of a small pump device with which the patient herself can control the dose administered according to her degree of pain.  A normal life style can be resumed within one to two weeks.

What Does Embolisation Involve?

Before the embolisation procedure, you will be given a comprehensive medical check-up.  

- a full physical and gynaecologogical examination carried out by your gynaecologist.

- imaging to gauge the number, size and location of the fibroids, carried out by a radiologist.

-  a complementary examination is required in order to determine the most suitable anaesthesia and pain management modalities.

During the procedure: the embolisation procedure is carried out by an interventional radiologist who is a radiologist with special training in navigation through vessels and treatment via a radiological approach.

You will be given drugs to control pain but you will remain conscious throughout the procedure. The radiologist will insert a small plastic tube -called a catheter- into an artery in the groin. With X-ray monitoring, the catheter is advanced until it reaches the uterine artery where small particles, each the size of a grain of sand, are injected into the vessels supplying the fibroids. This blocks the blood supply so that the fibroids shrink and the symptoms are attenuated.  

After the procedure: you will remain in hospital for one or two days for the management of post­operative pain. You will be able to return to work after 7 to 10 days. You may experience low fever and mild fatigue in the days following the procedure. Bleeding may also occur in the following months. The fibroids may be expelled spontaneously, although this is rare.

"The catheter is advanced until it reaches the  uterine artery where small particles, each the size of a grain of sand, are injected into the vessels supplying the fibroids. This blocks the blood supply so that the fibroids shrink and the symptoms are attenuated."

	Catheter that arrives until the uterine artery that mioma irrigates.
	With the positioned catheter it is come to the liberation of the microparticles.

Your interventional radiologist and gynaecologist will be working closely together and a follow-up will be done after the procedure.  Follow-up details vary but you will be asked to return for check-ups one and six months after embolisation.  

An ultrasound scan or a MRI examination is carried out after between 3 and 6 months.  

In any event, you should notify your physician about any abnormality you notice after embolisation.

Pregnancy after Uterine Artery Embolization?

Embolisation does not compromise fertility although the procedure is not at this time licensed for the correction of leiomyoma-related infertility.  

For more information send an email to Prof. Dr Ricardo Garcia Monaco: ricardo.garciamonaco@hospitalitaliano.org.ar

Prof. Dr. Ricardo Garcia Monaco website

For request of turns to communicate with Mrs. Patricia Pontieri to 4-959-0470.

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