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New Options Can Spare Women From Hysterectomy

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"This procedure has some real potential and will surely help save some uteruses," says Steven Clark, MD, professor of obstetrics and gynecology at the University of Utah School of Medicine, Salt Lake City.

Clark, who was not involved in the study, tells WebMD that embolization to stop postpartum bleeding is not new. What is new is the use of the balloons, called occlusion. The major drawback is that "it's not usually available in an emergency. But in those cases in which you can predict a high likelihood of bleeding and you have a little more time, I think this would be a good technique."

Razavi and his colleagues have also used embolization to shrink uterine fibroids. Many women have fibroids, benign growths that can cause pain, bleeding, and a feeling of heaviness in the uterus. Hysterectomy is the traditional treatment, but in addition to loss of fertility and the associated psychological impact, the operation can require four to six weeks of recuperation, he says.

To embolize the fibroids, the clinicians feed a catheter through the groin into the blood vessels that supply the fibroids, then inject tiny pellets into the vessels to block the circulation. With no blood to nourish them, the fibroids shrink, and symptoms are relieved.

The complications are significantly fewer than those associated with hysterectomy, and include infection, bruising of the groin area, and a theoretical risk of injecting the pellets into the wrong blood vessel. "All of these complications are benign except for infection," Razavi says. The procedure takes 60 to 90 minutes and requires only light sedation. Side effects include cramps and fatigue for up to a week after the procedure.

Although thousands of gynecologic patients have now undergone uterine fibroid embolization, it still requires some training on the part of the interventional radiologist performing it, as does the procedure to stop hemorrhaging after childbirth. Many community hospitals have no interventional radiologists or other specialists on staff who are skilled in either procedure, say experts speaking at the annual meeting of interventional radiologists in San Diego.

Women should consult their obstetrician-gynecologists or other health care providers to learn about the options in their communities.

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