title: Preoperative uterine artery embolization (PUAE) before uterine fibroid myomectomy.
abstract: OBJECTIVE
  To evaluate the potential of uterine artery embolization to minimize blood loss and facilitate easier removal of fibroids during subsequent myomectomy.
  
  
  METHODS
  This retrospective study included 22 patients (median age 37 years), of whom at least 15 wished to preserve their fertility. They presented with at least one fibroid (mean diameter 85.6 mm) and had undergone preoperative uterine artery embolization (PUAE) with resorbable gelatin sponge.
  
  
  RESULTS
  No complication or technical failure of embolization was identified. Myomectomies were performed during laparoscopy (12 cases) and laparotomy (9 cases). One hysterectomy was performed. The following were noted: easier dissection of fibroids (mean 5.6 per patient, range 1-30); mean intervention time 113 min (range 25-210 min); almost bloodless surgery, with a mean peroperative blood loss of 90 ml (range 0-806 ml); mean hemoglobin pretherapeutically 12.3 g/dl (range 5.9-15.2 g/dl) and post-therapeutically 10.3 g/dl (range 5.6-13.3 g/dl), with no blood transfusion needed. Patients were discharged on day 4 on average and the mean sick leave was 1 month.
  
  
  CONCLUSIONS
  Preoperative embolization is associated with minimal intraoperative blood loss. It does not increase the complication rate or impair operative dissection, and improves the chances of performing conservative surgery.
authors.affiliation: CHU Clermont Ferrand, Services de Radiologie B et Gynécologie, hôpital G. Montpied, F 63003, Clermont-Ferrand, France.
authors.forename: E
authors.initials: E
authors.lastname: Dumousset
authors.forename: P
authors.initials: P
authors.lastname: Chabrot
authors.forename: B
authors.initials: B
authors.lastname: Rabischong
authors.forename: N
authors.initials: N
authors.lastname: Mazet
authors.forename: S
authors.initials: S
authors.lastname: Nasser
authors.forename: C
authors.initials: C
authors.lastname: Darcha
authors.forename: J M
authors.initials: JM
authors.lastname: Garcier
authors.forename: G
authors.initials: G
authors.lastname: Mage
authors.forename: L
authors.initials: L
authors.lastname: Boyer
mesh_terms: D000328:Adult; D001158:Arteries; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015907:Hysteroscopy / Q000379:methods; D007813:Laparotomy / Q000379:methods; D007889:Leiomyoma / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D009215:Myometrium / Q000601:surgery; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000601:surgery*; D014599:Uterus / Q000098:blood supply*