Methods causing ischemia in uterine fibroids treatment
Authors:
P. Horák 1; M. Mára 1; P. Dundr 2; K. Kubínová 1; L. Hašlík 1; D. Kužel 1
Authors‘ workplace:
Gynekologicko-porodnická klinika VFN a 1. LF UK, Praha, přednosta prof. MUDr. A. Martan, DrSc.
1; Patologický ústav VFN a 1. LF UK, Praha, přednosta prof. MUDr. C. Povýšil, DrSc.
2
Published in:
Ceska Gynekol 2009; 74(4): 262-268
Category:
Original Article
Overview
Objective:
To compare principle, advantages, disadvantages, and risks of conservative (i.e. uterus saving) methods of treatment of uterine fibroids, which are focused on elimination or reduction of their perfusion. To contribute to better understanding of this dynamic topic between gynecologists, especially in the field of appropriate indication criteria.
Design:
Review article.
Setting:
Department of Obstetrics and Gynecology, Charles University and General Faculty Hospital, Prague.
Methods:
Analysis of literature and our clinical experience.
Conclusions:
Within the last decade the spectrum of treatment of uterine fibroids has broaden with methods causing ischemia of fibroids. These include the minimally invasive surgical therapy (laparoscopic occlusion of uterine arteries /LUAO/ and Doppler assisted laparoscopic myolysis) and radiological catheterization treatment (uterine artery embolization, UAE). Compared to foreign countries where UEA is mainly used in perimenopausal women, we focus on the group of patients with further fertility plans. It is necessary to stress that in spite of the number of affirmative experiences with the new techniques of uterine fibroid treatment in both the indication groups (women with or without further fertility plans) these methods still remain an alternative to standard surgical treatment, because both myomectomy and hysterectomy can be performed by minimally invasive techniques in the majority of women. This review is also focused on the specific risks of the particular methods as well as on their mechanism of action which may dramatically differ despite of some analogies.
Key words:
fibroids, uterine artery embolization, laparoscopic myolysis, laparoscopic occlusion of uterine arteries.
Sources
1. Arcangeli, S., Pasquarette, MM. Gravid uterine rupture after myolysis. Obstet Gynecol, 1997, 89, p. 857.
2. Ascher, S., Silverman, P. Applications of computed tomography and gynecologic disease. Urol Radiol, 1991, 13, p. 26-18.
3. Bergamini, V., Ghezzi, F., Cromi, A., et al. Laparoscopic radiofrequency thermal ablation: a new approach to symptomatic uterine myomas. Am J Obstet Gynecol, 2005, 192, p. 768-773.
4. Broder, MS., Goodwin, S., Chen, G., et al. Comparison of long-terms outcomes of myomectomy and uterine artery embolization. Obstet Gynecol, 2002, 100, p. 864-868.
5. Břešťák, M. jr., Pohl, K. Ultrazvukem vedená cílená laparoskopická ischemizace uterinních leiomyomů. Čes Gynek, 2003, 68, s. 152-155.
6. Carpenter, TT., Walker, WJ. Pregnancy following uterine artery embolization for symptomatic fibroids: a series of 26 completed pregnancies. BJOG, 2005, 112, p. 321-325.
7. Ciavattini, A., Tsiroglou, D., Piccioni, M., et al. Laparoscopic cryomyolysis: an alternative to myomectomy in women with symptomatic fibroids. Surg Endosc, 2004, 18, p. 1785-1788.
8. Clarke, B., McCluggage, WG. Iatrogenic lesions and artefacts in gynaecological pathology. J Clin Pathol, 2009, 62, p. 104-112.
9. D’Angelo, A., Amso, NN., Wood, A. Uterine leiomyosarcoma discovered after uterine artery embolization. J Obstet Gynecol, 2003, 23, p. 686–587.
10. Dickner, SK., Cooper, JM., Diaz, D. A nonincisional, Doppler-guided transvaginal approach to uterine artery identification and control of uterine perfusion. J Am Assoc Gynecol Laparosc, 2004, 11, p. 55-58.
11. Donnez, J., Squifflet, J., Polet, R., et al. Laparoscopic myolysis. Hum Reprod Update, 2000, 6, p. 609-613.
12. Dundr, P., Mára, M., Mašková, J., et al. Pathological findings of uterine leiomyomas and adenomyosis following uterine artery embolization. Pathol Res Pract, 2006, 202, p. 721-729.
13. Exacoustos, C., Zupi, E., Marconi, D., et al. Ultrasound-assisted laparoscopic cryomyolysis: two- and three-dimensional findings before, during and after treatment. Ultrasound Obstet Gynecol, 2005, 25, p. 393-400.
14. Goldberg, J., Pereira, L., Berghella, V. Pregnancy after uterine artery embolization. Obstet Gynecol, 2002, 100, p. 869-872.
15. Goodwin, SC., Bradley, LD., Lipman, JC., et al. UAE versus Myomectomy Study Group. Uterine artery embolization versus myomectomy: a multicenter comparative study. Fertil Steril, 2006, 85, p. 14-21.
16. Hald, K., KlŅw, NE., Qvigstad, E., Istre, O. Laparoscopic occlusion compared with embolization of uterine vessels: a randomized controlled trial. Obstet Gynecol, 2007, 109, p. 20-27.
17. Hald, K., Langebrekke, A., KlŅw, NE., et al. Laparoscopic occlusion of uterine vessels for the treatment of symptomatic fibroids: Initial experience and comparison to uterine artery embolization. Am J Obstet Gynecol, 2004, 190, p. 37-43.
18. Harman, M., Zeteroglu, S., Arslan, H., et al. Predictive value of magnetic resonance imaging signal and contrast-enhancement characteristics on post-embolization volume reduction of uterine fibroids. Acta Radiol, 2006, 47, p. 427-435.
19. Hirzel, F., Hess, T., Zollikofer, C. Quality control and quality of life after uterine fibroid embolization: long-term results. Gynakol Geburtshilfliche Rundsch, 2008, 48, p. 84-93.
20. Holub, Z., Kliment, L. Laparoscopic ultrasonic dissection of uterine vessels in women with benign uterine pathologies. Clin Exp Obstet Gynecol, 2002, 29, p. 54-56.
21. Holub, Z., Lukáč, J., Kliment, L., et al. Short-term results from laparoscopic dissection of uterine vessels in women with symptomatic fibroids. Eur J Obstet Gynecol Reprod Biol, 2003, 110, p. 94-98.
22. Holub, Z., Mára, M., Kužel, D., et al. Pregnancy outcomes after uterine artery occlusion: prospective multicentric study. Fertil Steril, 2008, 90, p. 1886-1891.
23. Holub, Z., Rokyta, Z., Kliment, L. Laparoscopic uterine artery dissection in an undiagnosed endometrial stromal sarcoma. Case report. Eur J Gynaecol Oncol, 2005, 26, p. 111-112.
24. Hovsepian, DM., Ratts, VS., Rodriguez, M., et al. A prospective comparison of the impact of uterine artery embolization, myomectomy, and hysterectomy on ovarian function. J Vasc Interv Radiol, 2006, 17, p. 1111-1115.
25. Chen, YJ., Wang, PH., Yuan, CC., et al. Pregnancy following treatment of symptomatic myomas with laparoscopic bipolar coagulation of uterine vessels. Hum Reprod, 2002, 18, p. 1077–1081.
26. Istre, O. Uterine artery occlusion for the treatment of symptomatic fibroids: endoscopic, radiological and vaginal approach. Minim Invasive Ther Allied Technol, 2005, 14, p. 167-174.
27. Kim, MD., Kim, NK., Kim, HJ., Lee, MH. Pregnancy following uterine artery embolization with polyvinyl alcohol particles for patients with uterine fibroid or adenomyosis. Cardiovasc Intervent Radiol, 2005, 28, p. 611-615.
28. Kim, MD., Lee, HS., Lee, MH., et al. Long-term results of symptomatic fibroids treated with uterine artery embolization: In conjunction with MR evaluation. Eur J Radiol, 2009, v tisku.
29. Kroencke, TJ., Scheurig, C., Lampmann, LE., et al. Acrylamido polyvinyl alcohol microspheres for uterine artery embolization: 12-month clinical and MR imaging results. J Vasc Interv Radiol, 2008, 19, p. 47-57.
30. Kubínová, K., Mára, M., Horák, P., et al. Novinky a perspektivy v radiologické léčbě děložních myomů. Čes Gynek, 2009, v tisku.
31. Lichtinger, M., Herbert, S., Memmolo, A. Temporary, transvaginal occlusion of the uterine arteries: a feasibility and safety study. J Minim Invasive Gynecol, 2005, 12, p. 40-42.
32. Liu, WM. Laparoscopic bipolar coagulation of uterine vessels to treat symptomatic leiomyomas. J Am Assoc Gynecol Laparosc, 2000, 7, p. 125-129.
33. Lohle, PN., Voogt, MJ., De Vries, J., et al. Long-term outcome of uterine artery embolization for symptomatic uterine leiomyomas. J Vasc Interv Radiol, 2008, 19, p. 319-326.
34. Mára, M., Fučíková, Z., Kužel, D., et al. Hysteroscopy after uterine fibroid embolization in women of fertile age. J Obstet Gynaecol Res, 2007, 33, p. 316-324.
35. Mára, M., Fučíková, Z., Mašková, J., et al. Uterine fibroid embolization versus myomectomy in women wishing to preserve fertility: preliminary results of a randomized controlled trial. Eur J Obstet Gynecol Reprod Biol, 2006, 126, p. 226-233.
36. Mára, M., Mašková, J., Fučíková, Z., et al. Poznámky k embolizaci děložních myomů. Čes Gynek, 2007, 72, p. 58-64.
37. Mára, M. Zobrazovací metody v diagnostice děložních myomů. Mod Gynek Porod, 2007, 16, p. 714-718.
38. Marshburn, PB., Mattheus, ML., Hurst, BS. Uterine artery embolization as a treatment option for uterine myomas. Obstet Gynecol North Am, 2006, 33, p. 125-144.
39. Mašková, J., Drbohlav, P., Křivánek, J., et al. První výsledky léčby symptomatických děložních myomů intraarteriální embolizací. Čes Radiol, 2001, 55, p. 364-369.
40. Murase, E., Siegelman, ES., Outwater, EK., et al. Uterine leiomyomas: histopathologic features, MR imaging findings, differential diagnosis, and treatment. Radiographics, 1999, 19, p. 1179-1197.
41. Ogliari, KS., Mohallem, SV., Barrozo, P., Viscomi, F. A uterine cavity-myoma communication after uterine artery embolization: two case reports. Fertil Steril 2005, 83, p. 220-222.
42. Park, KH., Kim, JY., Shin, JS., et al. Treatment outcomes of uterine artery embolization and laparoscopic uterine artery ligation for uterine myoma. Yonsei Med J, 2003, 44, p. 694-702.
43. Pelage, JP., Le Dref, O., Beregi, JP., et al. Limited uterine artery embolization with tris-acryl gelatin microspheres for uterine fibroids. J Vasc Interv Radiol, 2003, 14, p. 15-20.
44. Pron, G., Mocarski, E., Bennet, J., et al. Pregnancy after uterine embolization for leiomyomata: the Ontario multicenter trial. Obstet Gynecol, 2005, 105, p. 67–76.
45. Ravina, JH., Aymard, A., Ciraru-Vigneron, N., et al. Uterine fibroids embolization: results about 454 cases. Gynecol Obstet Fertil, 2003, 31, p. 597-605.
46. Ravina, JH., Ciraru-Vigneron, N., Aymard, A., et al. Pregnancy after embolization of uterine myoma: report of 12 cases. Fertil Steril, 2000, 73, p. 1241–1243.
47. Ravina, JH., Herbreteau, D., Ciraru-Vigneron, N., et al. Arterial embolisation to treat uterine myomata. Lancet, 1995, 346, p. 671-672.
48. Richter, GM., Radeleff, B., Rumbach, S., et al. Uterine fibroid embolization with spheric micro-particles using flow guiding: safety, technical success and clinical results. Rofo, 2004, 176, p. 1648-1657.
49. Santos, LM., Frenna, V., Thoma, V., et al. Disseminated intravascular coagulation after laparoscopic multiple myomectomy with use of icodextrin: a case report. J Minim Invasive Gynecol, 2006, 13, p. 480-482.
50. Sapmaz, E., Celik, H., Altungul, A. Bilateral ascending uterine artery ligation vs. tourniquet use for hemostasis in cesarean myomectomy. A comparison. J Reprod Med. 2003, 48, p. 950-954.
51. Siskin, GP., Shlansky-Goldberg, RD., Goodwin, SC., et al. A prospective multicenter comparative study between myomectomy and uterine artery embolization with polyvinyl alcohol microspheres: long-term clinical outcomes in patients with symptomatic uterine fibroids. J Vasc Interv Radiol, 2006, 17, p. 1287-1295.
52. Spies, JB., Allison, S., Flick, P., et al. Spherical polyvinyl alcohol versus tris-acryl gelatin microspheres for uterine artery embolization for leiomyomas: results of a limited randomized comparative study. J Vasc Interv Radiol, 2005, 16, p. 1431-1437.
53. Szydlovska, I., Starczewski, A. Laparoscopic coagulation of uterine myomas with the use of unipolar electrode. Surg Laparosc Endosc Percutan Tech, 2007, 17, p. 99-103.
54. Tavassoli, FA., Devilee, P. (eds.) WHO Classification of tumours. Pathology and genetics tumours of the breast and female genital organs. IARC Press: Lyon 2004.
55. Vidal, L., Michel, ME., Gavillon, N., et al. Pregnancy after uterine-artery embolization for symptomatic fibroids: a case of placenta accreta with uterine rupture. J Gynecol Obstet Biol Reprod (Paris), 2008, 37, p. 811-814.
56. Vilos, GA., Daly, LJ., Tse, BM. Pregnancy outcome after laparoscopic electromyolysis. J Am Assoc Gynecol Laparosc, 1998, 5, p. 289-292.
57. Vilos, GA., Vilos, EC., Romano, W., et al. Temporary uterine artery occlusion for treatment of menorrhagia and uterine fibroids using an incisionless Doppler-guided transvaginal clamp. Hum Reprod, 2006, 21, p. 269-271.
58. Vin, AP., Rhee, TK., Ryu, RK., et al. Use of a combined MR imaging and interventional radiology suite for intraprocedural monitoring of uterine artery embolization. J Vasc Interv Radiol, 2007, 18, p. 1362-1367.
59. Walker, WJ., McDowell, SJ. Pregnancy after uterine artery embolization for leiomyomata: a series of 56 completed pregnancies. Am J Obstet Gynecol, 2006, 195, p. 1266-1271.
60. Wang, PH., Liu, WM., Fuh, JL., et al. Symptomatic myoma treated with laparoscopic uterine vessel occlusion and subsequent immediate myomectomy: which is the optimal surgical approach? Fertil Steril, 2009, v tisku.
61. Weichert, W., Denkert, C., Gauruder-Burmester, A., et al. Uterine arterial embolization with tris-acryl gelatin microspheres. A histopathologic evaluation Am J Surg Pathol, 2005, 29, p. 955-961.
62. Worthington-Kirsch, RL., Pophy, GL., Hutchins, FL. Uterine artery embolization for the management of leiomyomas: quality of life assessment and clinical response. Radiology, 1998, 208, p. 625-629.
63. Zupi, E., Sbracia, M., Marconi, D., et al. Myolysis of uterine fibroids: is there a role? Clin Obstet Gynecol, 2006, 49, p. 821-833.
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