Interventional Gynaecology Treatments

These are a group of minimally invasive procedures to treat specific gynaecological conditions that would otherwise be treated with open invasive surgery. By using these minimally invasive methods, patients can expect to recover faster, experience less pain and be discharged home to rest on the same day of procedure.

Pelvic Congestion Syndrome


Pelvic Congestion Syndrome is a chronic condition affecting women and is caused by varicose veins in the lower abdomen or pelvis. 

Valves in the veins becoming weakened and do not close properly. As a result, blood begins to flow backwards and pools in the pelvic veins and also the connecting veins to the lower limbs.  

This condition typically affects women ages 20-50 that have had previous pregnancies. If symptomatic, they can be treated successfully with minimally invasive procedures.

Symptoms

  • An aching pain with heaviness in the pelvis that may extend to the lower back.  
  • Pain during intercourse
  • Heavy menstrual bleeding
  • Heaviness and swelling in their legs especially on standing for long periods.  

 

Diagnosis 

  • CT scan of the abdomen and pelvis
  • Pelvic venogram – a procedure that is performed by inserting a catheter through the groin vein and injecting a contrast agent (a type of dye) into the veins of the pelvic organs. 

 

Treatment – Ovarian Vein Embolization

  • the procedure inserting a thin catheter into the femoral vein in your groin. The catheter is guided to the affected vein with the assistance of fluoroscopy, a type of x-ray technology that allows the physician to visualize the veins.  Tiny titanium coils with a sclerosing agent (also used for varicose veins) are inserted through the catheter to close off the affected vein(s).
  • In most cases this is done as a day surgery procedure allowing patients to be discharged on the same day of procedure.

Uterine Fibroids

Uterine fibroids are common, non-cancerous tumors of the uterus. It’s estimated that by the age of 35, up to 40-50% of women may have uterine fibroids.   There are three basic types of uterine fibroids, classified according to their location in the uterus:

  1. Subserosal Fibroids: These develop in the outer portion of the uterus and continue to grow outward
  2. Intramural Fibroids: These are the most common type and develop in the uterine wall and expand
  3. Submucosal Fibroids: These are the least common and develop within the uterine cavity, causing excessive and prolonged menstrual bleeding
  4. Pedunculated fibroids grow on stalks or stems. These stems are attached to the uterine wall and can grow either outside the uterus or inside the uterine cavity

 

Symptoms

In some women, fibroids can produce mild or no symptoms at all. For others, symptoms of uterine fibroids include:

  • Abnormal menstrual cycle (heavy or frequently occurring)
  • Painful menstrual periods
  • Pain during or after sexual intercourse
  • Pressure on the bladder causing frequent urination
  • Acute or severe pelvic pain
  • Bloating

 

Diagnosis

  • an ultrasound scan of the uterus
  • Sometimes a CT scan is ordered especially if there are multiple fibroids

 

Treatment – Uterine Fibroid Embolization (UFE)

UFE is done via a groin or radial artery access puncture.  A catheter is then guided using fluoroscopy to the arteries that supply the uterus and the fibroids specifically.  Small particles or microspheres are then injected into the arteries supplying the fibroids, thus cutting off the blood supply to the fibroids. Post-procedure, these fibroids should start to shrink and reduce in size. 

 

Who is a Candidate for UFE

You are a good candidate for UFE if you:

  • Are a woman who is over the age of 35
  • Are not currently pregnant
  • Have been diagnosed with uterine fibroids
  • Are experiencing symptoms such as excessive heavy bleeding, cramping, pelvic pain, bloating or frequent urination

You are also a candidate if you prefer a non-surgical uterine fibroid treatment option that will preserve your uterus. Make sure to discuss all options with your physician before making a decision.

 

Benefits of UFE

  • Minimally invasive procedure that safely and effectively shrinks uterine fibroids
  • Requires only local (rather than general) anaesthesia
  • Does not cause scarring like surgical techniques do
  • While there will be some moderate pain after a UFE procedure, it is typically less intensive than post-surgical pain
  • A good option if you would like to preserve your uterus vs. a hysterectomy
  • 85-90% of women experience significant relief of their symptoms
  • Faster recovery time compared to surgery
  • Same day procedure with typically no overnight stay
  • Reduced risk of infection as compared to surgery
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