Uterine artery embolization for the treatment of fibroids.
ABSTRACT Uterine artery embolization (UAE), or uterine fibroid embolization, is a non-surgical treatment for uterine fibroids that preserves the uterus and offers women an alternative to surgical procedures such as hysterectomy and myomectomy. Evidence from controlled trials comparing fibroid treatments is not yet available. Case series reports indicate that UAE is a relatively safe and effective treatment for symptomatic fibroids. The effect of UAE on fertility and pregnancy is not known, though pregnancies following UAE have been reported. UAE may reduce health care costs associated with treating fibroids through shorter hospital stays and faster recoveries.
Chapter: Uterine Fibroids01/2012: pages 438-469;
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ABSTRACT: To evaluate whether it is safe to perform uterine artery embolization (UAE) as an outpatient procedure. This retrospective study was approved by the institutional review board and included 234 patients (age range, 24-58 years; mean age, 40.5 years) who underwent UAE as an outpatient procedure with polyvinyl alcohol particles between January 2007 and March 2008. Patients were given acid-suppressing drugs, nonsteroidal anti-inflammatory drugs, anti-histaminic drugs, and laxatives twice on the day before UAE and once on the morning of UAE. Pain score, rated from 0 to 10, was evaluated by using a numeric pain scale during UAE, after the procedure, at discharge, at the night of discharge, and on the following morning. The outcome of UAE was evaluated at 6 months by means of pelvic magnetic resonance imaging and clinical observation. The mean pain score was 0.9 during embolization, 2.5 4-8 hours after embolization, 0.9 at discharge, 1.1 the first night after discharge, and 0.7 the next morning. All patients were discharged from the hospital 4-8 hours after the procedure, with no overnight hospital admissions. At 6 months, 146 of 158 patients (92.4%) reported an improvement in menorrhagia, 39 of 44 (88.6%) reported an improvement in bulk symptoms, and 20 of 25 (80%) reported an improvement in pain. The volumes of the uterus and the dominant fibroid decreased 33.7% and 39.3%, respectively. With acid-suppressing, anti-inflammatory, and anti-histaminic drugs started on the day before UAE, the procedure can be performed safely as an outpatient procedure.Journal of vascular and interventional radiology: JVIR 04/2009; 20(6):730-5. · 1.81 Impact Factor
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ABSTRACT: Gene therapy is the introduction of genetic material into patient's cells to achieve therapeutic benefit. Advances in molecular biology techniques and better understanding of disease pathogenesis have validated the use of a variety of genes as potential molecular targets for gene therapy based approaches. Gene therapy strategies include: mutation compensation of dysregulated genes; replacement of defective tumor-suppressor genes; inactivation of oncogenes; introduction of suicide genes; immunogenic therapy and antiangiogenesis based approaches. Preclinical studies of gene therapy for various gynecological disorders have not only shown to be feasible, but also showed promising results in diseases such as uterine leiomyomas and endometriosis. In recent years, significant improvement in gene transfer technology has led to the development of targetable vectors, which have fewer side-effects without compromising their efficacy. This review provides an update on developing gene therapy approaches to treat common gynecological diseases such as uterine leiomyoma and endometriosis.Advanced drug delivery reviews 06/2009; 61(10):822-35. · 11.96 Impact Factor