[Methods using ischemia in uterine fibroids treatment].
OBJECTIVE
To compare principle, advantages, disadvantages, and risks of conservative (i.e. uterus saving) methods of treatment of uterine fibroids, which are focused on elimination or reduction of their perfusion. To contribute to better understanding of this dynamic topic between gynecologists, especially in the field of appropriate indication criteria.


METHODS
Review article.


METHODS
Department of Obstetrics and Gynecology, Charles University and General Faculty Hospital, Prague.


METHODS
Analysis of literature and our clinical experience.


CONCLUSIONS
Within the last decade the spectrum of treatment of uterine fibroids has broaden with methods causing ischemia of fibroids. These include the minimally invasive surgical therapy (laparoscopic occlusion of uterine arteries /LUAO/ and Doppler assisted laparoscopic myolysis) and radiological catheterization treatment (uterine artery embolization, UAE). Compared to foreign countries where UEA is mainly used in perimenopausal women, we focus on the group of patients with further fertility plans. It is necessary to stress that in spite of the number of affirmative experiences with the new techniques of uterine fibroid treatment in both the indication groups (women with or without further fertility plans) these methods still remain an alternative to standard surgical treatment, because both myomectomy and hysterectomy can be performed by minimally invasive techniques in the majority of women. This review is also focused on the specific risks of the particular methods as well as on their mechanism of action which may dramatically differ despite of some analogies.
Horák
Petr
P
Gynekologicko-porodnická klinika VFN a 1. LF UK, Praha.
Mára
M
M
Dundr
P
P
Kubínová
K
K
Haslík
L
L
Kuzel
D
D
D005260:Female; D006801:Humans; D010535:Laparoscopy; D007889:Leiomyoma / Q000097:blood / Q000628:therapy*; D055988:Uterine Artery / Q000601:surgery*; D055357:Uterine Artery Embolization; D014594:Uterine Neoplasms / Q000098:blood supply / Q000628:therapy*