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The selection
of a patient for Uterine Artery Embolization (UAE) first requires
the expertise and judgement of the gynecologist. UAE may be indicated
or recommended for women refusing traditional surgical treatments
for fibroids or for women that have medical problems that make traditional
surgery complicated. Medical problems may include the presence of
cardiovascular disease, chronic obstructive pulmonary disease, or
prior pelvic surgery with pelvic adhesions and scarring. The most
common indication for uterine artery emolization may be a women's
desire to avoid surgery, long post - operative recovery and the
desire to keep her uterus intact. After the initial evaluation by
the gynecologist, the patient should meet and discuss with the interventional
radiologist, all treatment options, and expectations for the procedure.
An ideal candidate
for UAE is a woman that has: severe pain and/or bleeding from fibroids,
a fibroid that is visible, painful intercourse from fibroids, has
a desire to retain her uterus, does not want children in the future,
and would like to avoid the weeks of recovery time of traditional
surgery. Patients who have had a history of prior pelvic x-ray treatments,
a history of pelvic malignancy, chronic infections or severe endometriosis
should not undergo uterine artery embolization.
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85
- 90% of women will experience significant improvement in their
symptoms associated with fibroids, (excessive bleeding and pelvic
pain) within two months. Eighty - eight percent (88%) of patients
report marked improvement in their abnormal bleeding starting with
their first menstrual period after the procedure. 37% reported complete
resolution of abnormal bleeding after embolization, 38% reported
great improvement and 13% reported moderate improvment. Relief of
pain symptoms was also good, although not as dramatic as the change
in abnormal bleeding. 94% of patients reported substantial improvment
in pain symptoms, with 19% reporting complete resolution of symptoms,
39% reporting great improvment and 35% moderate improvment. 6% of
patient report no change in pain symptoms.
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