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Embolization of uterine arteries

In modern gynecology and obstetrics more than 20 years as a stop of postoperative and postnatal bleedings the embolization of uterine arteries is applied.

Now this procedure is widely applied in treatment of myoma of a uterus, it allows to avoid conservative treatment. This procedure consists in occlusion (obstruction) of blood vessels by means of a puncture of a femoral artery. As operation is painless practically, for its carrying out appoint local anesthesia. For many years to women with the diagnosis of myoma of a uterus appointed a resection, up to full removal of a uterus. The most frequent indication to operation was the assumption of a high share of probability of regeneration of a fibromioma in a malignancy. Amputation of a uterus which is very hard transferred by women and, as a rule, leads to a heavy depression, to this day remains in the most widespread way of a gynecologic hysterectomy (surgery).

Description

The new method was the real rescue for women from difficult operation, thanks to possibility of an overshoot of the blood-groove supplying with blood fibromatous knots. As a result of carrying out this procedure, myoma very quickly decreases in sizes. Embolization of arteries of a uterus consists in introduction embol in a uterine artery, by means of a small puncture in an inguinal fold. The endovascular surgeon by means of the x-ray equipment attentively traces movement of a catheter in an artery and consistently brings it to a uterine artery, stopping in a point where it branches. Thus, medical process consists in a puncture of a femoral artery, a further katerization of uterine vessels and the subsequent introduction of an embolizatsionny preparation which gets stuck in vessels and blocks them. Procedure is considered complete after full obstruction of the blood vessels which are responsible for blood supply of myoma. For achievement of the guaranteed result the embolization of uterine arteries is carried out from both parties. As confirmation of the termination of blood supply of knots carry out a control arteriogramma. Places of punctures are carefully processed by antiseptic solution and for 12 hours are squeezed by a sterile bandage.

Purpose of a method

Clinical classification of myoma of a uterus defines a method of treatment of patients:

  • at small (1-2 centimeters) myomas the combined oral contraceptives (COOKS) or intrauterine releasing-system appoint;
  • in the presence of myomas of the average sizes (3-4 centimeters) appoint two-stage treatment;
  • at detection of big myomas (over 4,5 centimeters) appoint a conservative miomektomiya (removal of myoma) or an embolization of uterine arteries;
  • myomas on a leg demand laparoscopic (through a small opening) removal;
  • submukozny (submucous) myomas, up to 3 centimeters in size demand a gisterorezektoskopiya (intrauterine surgery).

To carrying out an embolization of uterine arteries there are certain indications and contraindications. Embolization of arteries of a uterus is allowed in the following cases:

  1. When the diagnosis of the simptomny or growing uterus myoma is established

    purpose of procedure is recommended:

    • at establishment of the sizes of a uterus corresponding to pregnancy from 7 to 20 weeks, but it is exclusive on condition of absence of pathology an endometriya, ovaries and a neck of a uterus. Carrying out an embolization with smaller sizes of a uterus is undesirable because success of its carrying out is absolutely insignificant;
    • at interest of women in preservation of reproductive function, along with the established influence of myoma in pathogenesis of infertility or the assumption of high probability of an abortion;
    • when carrying out preparatory activities to a miomektamiya (removal of myoma) or a gisterorezektoskopiya (intrauterine surgery).
    • at considerable bleedings of a uterus of various etiology when all other ways of treatment pose hazard to life of the patient.
  2. Carrying out an embolization can be contraindicated in cases of identification of infectious process or existence of the expressed allergy to the used preparations leading to Kvinke's hypostasis or anaphylactic shock.

Advantages of procedure

Embolization of arteries of a uterus has a number of advantages in comparison with other methods of treatment. It is possible to carry the next positive moments to them:

  1. Possibility of prevention of surgical intervention and the guaranteed preservation of a uterus.
  2. Continuation of reproductive ability of the woman.
  3. Avoiding of application of the general anesthesia and fast restoration after an eight-hour bed rest.
  4. Absence of big scars and injuries of skin. Traces from two punctures very quickly disappear.
  5. In case of temperature increase or pain that meets extremely seldom, rather small course of anti-inflammatory preparations and anesthetics.

Numerous responses of grateful women unanimously testify that procedure is painless absolutely and no more than 10 minutes last. Along with full preservation of functions of a uterus, progressing of a tumor completely stops and quickly enough there is its reduction in sizes.

In end of article it is necessary to add that at the moment the mimoma of a uterus began to be diagnosed much more often for young girls who not only did not manage to learn pleasure of motherhood, but also to enter full-fledged adult life. In the conditions of modern clinic carrying out an embolization of arteries of a uterus for the present is quite expensive procedure. However, it is necessary to recognize that this method really is worth it. Total amount of carrying out procedure joins the price of an emboliziruyushchy preparation, the used tools and materials, work of the doctor, and also stay in a hospital.

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This photo is made on the rooftop No. 26 on Nevsky Avenue on July 1, 1882. On it the staff of firm of Bell who just brought the Russia's first telephone exchange into operation. At the time of opening in Moscow and St. Petersburg there were about 130 subscribers.