Book contents
- Frontmatter
- Contents
- Contributors
- Preface
- Foreword
- 1 Uterine fibroids: epidemiology and an overview
- 2 Histopathology of uterine leiomyomas
- 3 Imaging of uterine leiomyomas
- 4 Abdominal myomectomy
- 5 Laparoscopic managment of uterine myoma
- 6 Hysteroscopic myomectomy
- 7 Myomas in pregnancy
- 8 Expectant and medical management of uterine fibroids
- 9 Hysterectomy for uterine fibroid
- 10 History of embolization of uterine myoma
- 11 Uterine artery embolization – vascular anatomic considerations and procedure techniques
- 12 Pain management during and after uterine artery embolization
- 13 Patient selection, indications and contraindications
- 14 Results of uterine artery embolization
- 15 Side effects and complications of embolization
- 16 Reproductive function after uterine artery embolization
- 17 Reasons and prevention of embolization failure
- 18 Future of embolization and other therapies from gynecologic perspectives
- 19 The future of fibroid embolotherapy: a radiological perspective
- Index
- Plate section
17 - Reasons and prevention of embolization failure
Published online by Cambridge University Press: 10 November 2010
- Frontmatter
- Contents
- Contributors
- Preface
- Foreword
- 1 Uterine fibroids: epidemiology and an overview
- 2 Histopathology of uterine leiomyomas
- 3 Imaging of uterine leiomyomas
- 4 Abdominal myomectomy
- 5 Laparoscopic managment of uterine myoma
- 6 Hysteroscopic myomectomy
- 7 Myomas in pregnancy
- 8 Expectant and medical management of uterine fibroids
- 9 Hysterectomy for uterine fibroid
- 10 History of embolization of uterine myoma
- 11 Uterine artery embolization – vascular anatomic considerations and procedure techniques
- 12 Pain management during and after uterine artery embolization
- 13 Patient selection, indications and contraindications
- 14 Results of uterine artery embolization
- 15 Side effects and complications of embolization
- 16 Reproductive function after uterine artery embolization
- 17 Reasons and prevention of embolization failure
- 18 Future of embolization and other therapies from gynecologic perspectives
- 19 The future of fibroid embolotherapy: a radiological perspective
- Index
- Plate section
Summary
This chapter will examine the failures of uterine artery embolization (UAE) in our center. The overall results of UAE and our standard to define failures have been discussed in Chapter 14. In short, these standards are minimal or no shrinkage, no relief of symptoms, and hysterectomy. Here, we will also discuss technical failures and failures to achieve fertility.
Excluded patients
In our practice, we perform endoscopic evaluations of the uterus, as well as taking into account the possible contraindication or factors that may lead to failure. We exclude patients prior to embolization using the scheme outlined in the Chapter 14. Prevention of failure starts with selecting the correct procedure. We have excluded six patients with gynecologic malignancy. Twelve patients who presented with acute uterine hemorrhage and were embolized prior to endoscopic evaluation on an emergency basis were evaluated with endoscopy after embolization. One of these patients was discovered to have a malignancy and was referred for a definitive therapy. We also excluded 22 patients with atypical endometrial hyperplasia and eight patients with acute pelvic infection.
Definition of failure
Minimal shrinkage
Shrinkage alone is not a sole criterion of success. Later in this chapter, we will analyze patients who presented with uterine shrinkage of 50%, but they could not be categorized into the success group.
- Type
- Chapter
- Information
- Uterine FibroidsEmbolization and other Treatments, pp. 125 - 132Publisher: Cambridge University PressPrint publication year: 2003