Treatments: UAE: Example: For Physicians

UAE - An Example Case for Physicians
A 40 year old woman, gravida 2 para 2, presented with a 10 month history of worsening menorrhagia and chronic pelvic discomfort. Physical examination revealed an enlarged, lobulated uterus of approximately 15 week gestational size. Ultrasound examination revealed multiple hypoechoic masses in an enlarged uterus, representing multiple fibroids. Hemoglobin was 9.6 g (moderate anemia), despite 6 months of oral iron replacement. Serum beta HCG was negative. The remainder of the history, physical, and laboratory examination were essentially normal.

The patient expressed a strong desire to avoid a surgical procedure, thus uterine artery embolization was elected as the primary management. The procedure was performed under intravenous conscious sedation. Approximately 100 mL of iodinated contrast material were used. The therapeutic portion required 10cc of Tris-Acryl/Collagen hydrojel embolic particles.

After the procedure, the patient developed moderate to severe postembolization cramping. This was controlled with intravenous narcotics. The remainder of the postprocedure course was uneventful. The patient was much more comfortable at 12 hours and was discharged with Ibuprofen for pain control.

During follow-up, the menorrhagia has stopped. Normal menses have been maintained. At 5 months follow-up, the patient's hemoglobin is 15 g (normal). There has been significant improvement in the patient's chronic pelvic discomfort. Ultrasound at 3 months postprocedure showed a 53% decrease in uterine volume.The relief of symptoms has been stable for over 4 years to date.

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