Prehysterectomy embolisation of uterine arteries for large uterine fibroids—a report

Hysterectomy for large uterine fibroids can prove to be a technically difficult procedure. The irregular shape of the uterus filling the pelvis may make access to the pedicles difficult. The larger the size of the uterus, the greater the risk of significant blood loss and trauma to the surrounding structures. Uterine artery embolisation (UAE) has been in use since 1991 as a “noninvasive” treatment for uterine fibroids and has had encouraging results. Various workers have reported success rates between 86% and 100%. We present here our experience with two patients who underwent embolisation of the uterine arteries, followed by hysterectomy. In both cases, patients had symptomatic uterine fibroids and no desire to conceive. The patients were counselled about the combined treatment and other treatment alternatives available to enable them make an informed choice.