Fauconnier A, Pelage J-P, Lacombe P, Ville Y
Service de gynécologie-obstétrique, CHI Poissy-Saint-Germain, 20, rue Armagis, 78105 Saint-Germain-en-Laye, France.
Gynecol Obstet Fertil. 2004 Sep;32(9):818-24. doi: 10.1016/j.gyobfe.2004.07.014.
Uterine artery embolization is a recent technique intended for treating uterine fibroids, as an alternative to hysterectomy. The possible side effects putting at stake the prognosis of fertility after embolization are considered as a brake to its use for the treatment of infertility associated with myoma. Secondary hysterectomy and permanent amenorrhea are the two main risks. But they are not so frequent and can be prevented. To date, the experience in the field of fertility and pregnancy after arterial embolization for fibroids is quite limited. However, first results are encouraging and not very different from those observed after surgical myomectomy. A therapeutic trial using arterial embolization for the management of fibroids within a context of infertility can be devised in the presence of submucosal or intramural myomas responsible for metromenorrhagia and with no major infertility factors associated. It is likely that uterine artery embolization should provide results equivalent or superior to those of surgical myomectomy in case of numerous and intramural fibroids with no prevailing myoma. Arterial embolization could be also interesting in case of recurrent myoma after laparotomic myomectomy.
子宫动脉栓塞术是一种用于治疗子宫肌瘤的新技术，可作为子宫切除术的替代方法。栓塞后可能影响生育预后的副作用被认为是其用于治疗与肌瘤相关不孕症的障碍。二次子宫切除术和永久性闭经是两个主要风险。但它们并不常见且可以预防。迄今为止，子宫肌瘤动脉栓塞术后生育和妊娠领域的经验相当有限。然而，初步结果令人鼓舞，与手术切除肌瘤后观察到的结果并无太大差异。对于因黏膜下或壁间肌瘤导致月经过多且无主要不孕因素的不孕症患者，可设计一项使用动脉栓塞术治疗肌瘤的治疗试验。对于多发性壁间肌瘤且无优势肌瘤的情况，子宫动脉栓塞术可能会提供与手术切除肌瘤相当或更好的结果。对于剖腹肌瘤切除术后复发肌瘤的情况，动脉栓塞术也可能是有意义的。
