Tratamento das pacientes sintomáticas portadoras de miomas uterinos através da associação das técnicas de embolização dos miomas e ligadura endovascular das artérias uterinas / Uterine artery embolization with polyvinyl-alcohol particles and metallic coils for the treatment of symptomatic patients with fibroids




Uterine fibroids are the most frequent benign tumors of the female genital tract. The tumors are symptomatic in about 30% of the cases, requiring medical treatment. In the present study, a total of 35 clinically symptomatic patients with ultrasonographic diagnosis of fibroids underwent endovascular treatment, which consisted of embolization of the uterine arteries with 355-500 micras PVA particles associated to metallic coils. Clinical and ultrasonographic evaluations were performed at baseline, 1, 3, 6 and 12 months post-intervention. Technical success was obtained in 94.3% of the cases. Mean uterine volume before the procedure was 404.53 cm³ and menorrhagia was the most frequent symptom (82.9%). Mean reduction of the uterine volumes was 21.4%, 39.7%, 53.8% and 59.8% respectively at 1, 3, 6 and 12 months post-intervention. Dominant fibroid size was also significantly reduced after the procedure (5%, 18.5%, 26.8% and 32.9% reductions at 1, 3, 6 and 12 months, respectively; p <0.01). Vaginal bleeding was abolished in all cases after the 12-month follow up. One patient needed to undergo hysterectomy 6 months after the procedure due to uncontrolled pain. Our results demonstrate uterine arteries embolization is minimally invasive and provides clinical control of the fibroids associated to significant reduction of the uterine volume. Moreover, the technique preserves the uterus and should be considered a therapeutic alternative to standard surgical treatment.


mioma/diagnóstico polyvinil alcohol arteries embolization therapeutic menorrhagia artérias myoma/diagnosis embolização terapêutica uterus analgesia patient-controlled Útero menorragia analgesia controlada pela paciente Álcool de polivinil

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