Clinical and morphological features of fibroids in women of reproductive age after previously performed inefficient UAE, MRgFUS ablation and myomectomy.
Irina Porotikova (RU), Tatiana Gavrilova (RU), Tatiana Demura (RU), Leial Adamyan (RU)
[Porotikova] Russian Scientific Center for Obstetrics, Gynecology and perinatology, [Gavrilova] Russian Scientific Center for obstetrics, gynecology and perinatology, [Demura] Russian Scientific Center for obstetrics, gynecology and perinatology, [Adamyan] Russian Scientific Center for obstetrics, gynecology and perinatology
Context: due to the introduction of new methods of treatment, such as UAE, MRgFUS ablation of fibroids, it is interesting to assess their effectiveness, and influence on reproduction. Objectives: To estimate the character of clinical and morphological changes of the reproductive system in women after previously undergoing ineffective UAE, MRgFUS ablation and myomectomy. Methods: clinical, morphological Patients: 110 women reproductive age with a history of ineffective treatment of uterine fibroids with using of UAE, MRgFUS ablation and myomectomy. Group I -32 patients with a history of UAE, II group- 26 patients with a history of MRgFUS ablation of fibroids and III group- 52 patients previously undergone myomectomy. Interventions: surgical treatment-myomectomy Main Outcome Measures: The indications for surgical treatment were: menorrhagia (80.2%), pelvic pain (70%), absence of pregnancy (95%). Nearly in 40% of all observed patients our surgical treatment allowed to get pregnancy. Results: in the group after UAE in 40% of patients with uterine body was represented by conglomerates of multiple fibroids with pronounced signs of secondary changes, compared to 26% in the group after MRgFUS ablation, where were only secondary changes in the nodes. Increased diffuse bleeding tissue in UAE group was observed in 46.0% of patients and main part of operations were carried out in a reinfusion of erythrocytes. Clinical data coincide with the data of morphological studies. Necrosis was detected in 55,2%, edema was detected in 44,8% of cases in I group. A statistically significant number of the largest growth areas and calcification were detected in the group after UAE. Conclusions: This study demonstrate necessary of future research, including the development of clear indications for UAE and MRgFUS ablation in reproductive age patients.