uterrine artery embolozation

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1、JenniferGreenmanHMSIIIGillianLieberman,MDUterineArteryEmbolizationJenniferGreenman,HMSIIIGillianLieberman,MDJenniferGreenmanHMSIIIGillianLieberman,MDOurPatient:Mrs.L37yearoldAfricanAmericanwomanpresentedwithcomplaintsofworseningabdominalcramping,dysmenorrhea,menorrhagia,andintermittentconstipa

2、tion5yearhistoryofuterinefibroidsGynecologistnotedprogressiveenlargementofasingleintramuraluterinefibroid;physicalexamwasremarkableforatender,20-week-sizeuterusw/opregnancyRecentPapsmearandendometrialbiopsiesWNLAfteratrialofaspirinfailedtoalleviatehersymptoms,Mrs.LconsultedIRforpotentialbil

3、ateralUterineArteryEmbolization(UAE)therapyJenniferGreenmanHMSIIIGillianLieberman,MDUterineFibroids(leiomyomas)BenigntumorsarisingfromuterinesmoothmuscleUnknownetiology:hormonedysregulationandgeneticfactorslikelycontributoryHighprevalenceofasymptomaticpatientscloudstrueincidence;estimatesgen

4、erallyrangefrom20to50%ofwomenofchild-bearingage,makinguterinefibroidsthemostcommonsolidtumorofthegenitaltractinwomenRiskfactorsincludeapositivefamilyhistory,nulliparity,andobesityElevatedfrequencyinAfro-CaribbeanwomenJenniferGreenmanHMSIIIGillianLieberman,MDFibroidClassificationbyLocation•Sub

5、mucosal:bulgeintotheendometrialcavity;mostoftenassociatedwithheavymenstrualbleedingandinfertility•Intramural:withinthemuscularwalloftheuterusandsurroundedbynormaluterinetissue;fewestassociatedsymptoms•Subserousal:developintheserosa;pedunculatedsubtypemaytorseandcausepainwww.ufeinfo.comJenniferG

6、reenmanHMSIIIGillianLieberman,MDSymptomsUterovaginalbleedingMenorrhagiaand/orrefractoryanemiaFeelingsofabdominalpressure,discomfort,orpainConstipationUrinarydisturbancesDyspareuniaLowerbackpainJenniferGreenmanHMSIIIGillianLieberman,MDSymptoms(cont.)Symptomsarerelatedtotheposition,size,an

7、ddirectionoftumorgrowth:Submucosalfibroidsmayincreasetheendometrialsurface,resultinginalargerbleedingareaSubserousandintramuraltumorsmaypredominantlydisturbuterinecontractilityJenniferGreenmanHMSIIIGillianLieberman,MDSymptoms(co