Pelvic Congestion Syndrome - Chronic Pelvic Pain in Women

Non-Surgical Treatment - Pelvic congestion syndrome 

It is estimated that one-third of all women will experience chronic pelvic pain in their lifetime. Many of these women are told the problem is "all in their head" but recent advancements now show the pain may be due to hard to detect varicose veins in the pelvis, known as pelvic congestion syndrome.

The causes of chronic pelvic pain are varied, but are often associated with the presence of ovarian and pelvic varicose veins. Pelvic congestion syndrome is similar to varicose veins in the legs. In both cases, the valves in the veins that help return blood to the heart against gravity become weakened and don't close properly, this allows blood to flow backwards and pool in the vein causing pressure and bulging veins. In the pelvis, varicose veins can cause pain and affect the uterus, ovaries and vulva. Up to 15 percent of women, generally between the ages of 20 and 50, have varicose veins in the pelvis, although not all experience symptoms.

The diagnosis if often missed because women lie down for a pelvic exam, relieving pressure from the ovarian veins, so that the veins no longer bulge with blood as they do while a woman is standing.

Many women with pelvic congestion syndrome, spend many years trying to get an answer to why they have this chronic pelvic pain. Living with chronic pelvic pain is difficult and affects not only the woman directly, but also her interactions with her family, friends, and her general outlook on life. Because the cause of the pelvic pain is not diagnosed, no therapy is provided even though there is therapy available.

If you have pelvic pain that worsens throughout the day when standing, you may want to seek a second opinion with an interventional radiologist, who can work with your gynecologist. You can ask for interventional radiology. 

Prevalence

• Women with pelvic congestion syndrome are typically less than 45 years old and in their child bearing years.
• Ovarian veins increase in size related to previous pregnancies. Pelvic congestion syndrome is unusual in women who have not been pregnant.
• Chronic pelvic pain accounts for 15% of outpatient gynecologic visits.
• Studies show 30% of patients with chronic pelvic pain have pelvic congestion syndrome (PCS) as a sole cause of their pain and an additional 15% have PCS along with another pelvic pathology.

Risk Factors

• Two or more pregnancies and hormonal increases
• Fullness of leg veins
• Polycystic ovaries
• Hormonal dysfunction

Symptoms

The chronic pain that is associated with this disease is usually dull and aching. The pain is usually felt in the lower abdomen and lower back. The pain often increases during the following times:

• Following intercourse
• Menstrual periods
• When tired or when standing (worse at end of day)
• Pregnancy

Other symptoms include:

• Irritable bladder
• Abnormal menstrual bleeding
• Vaginal discharge
• Varicose veins on vulva, buttocks or thigh.

Diagnosis and Assessment

Once other abnormalities or inflammation has been ruled out by a thorough pelvic exam, pelvic congestion syndrome can be diagnosed through several minimally invasive methods. An interventional radiologist, a doctor specially trained in performing minimally invasive treatments using imaging for guidance, will use the following imaging techniques to confirm pelvic varicose veins that could be causing chronic pain.

Pelvic venography: Thought to be the most accurate method for diagnosis, a venogram is performed by injecting contract dye in the veins of the pelvic organs to make them visible during an X-ray. To help accuracy of diagnosis, interventional radiologists examine patients on an incline, because the veins decrease in size when a woman is lying flat.

MRI: May be the best non-invasive way of diagnosing pelvic congestion syndrome. The exam needs to be done in a way that is specifically adapted for looking at the pelvic blood vessels. A standard MRI may not show the abnormality.

Pelvic ultrasound: Usually not very helpful in diagnosing pelvic congestion syndrome unless done is an very specific manner with the patient standing while the study is being done. Ultrasound may be used to exclude other problems that might be causing pelvic pain.

Transvaginal ultrasound: This technique is used to see better inside the pelvic cavity. As with a pelvic ultrasound it is not very good at visualizing the pelvic veins unless the woman is standing. However it may be used to exclude other problems.

                                       Treatment Options - Embolization

Once a diagnosis is made, if the patient is symptomatic, an embolization should be done. Embolization is a minimally invasive procedure performed by interventional radiologists using imaging for guidance. During the outpatient procedure, the interventional radiologist inserts a thin catheter, about the size of a strand of spaghetti, into the femoral vein in the groin and guides it to the affected vein using X-ray guidance. To seal the faulty, enlarged vein and relieve painful pressure, an interventional radiologist inserts tiny coils often with a sclerosing agent (the same type of material used to treat varicose veins) to close the vein. After treatment, patients can return to normal activities immediately.

Additional treatments are available depending on the severity of the woman's symptoms. Analgesics may be prescribed to reduce the pain. Hormones such birth control pills decrease a woman's hormone level causing menstruation to stop may be helpful in controlling her symptoms. Surgical options include a hysterectomy with removal of ovaries, and tying off or removing the veins.

Fig 1 : USG Doppler study of pelvis shows prominent ovarian veins.
Fig 2 : Ovarian vein venography shows dilated veins in pelvis cause of chronic pelvic pain.
Fig 3 : blocking of dilated ovarian vein by multiple coiles.


Efficacy

In addition to being less expensive to surgery and much less invasive, embolization offers a safe, effective, minimally invasive treatment option that restores patients to normal. The procedure is very commonly successful in blocking the abnormal blood flow. It is successfully performed in 95-100 percent of cases. A large percentage of women have improvement in their symptoms, between 85-95 percent of women are improved after the procedure. Although women are usually improved, the veins are never normal and in some cases other pelvic veins are also affected which may require further treatment.

Dr. Pradeep Muley M.D.

Head & Senior Consultant Interventional Radiologist

Fortis Hospital, Vasant Kunj, New Delhi, India

Fellow, Neurointerventional Radiology, John’s Hopkins Medical Institutions, USA

Visiting Associate, Neurointerventional Radiology, Iowa University, USA

Fellow Interventional Radiology, Singapore General Hospital, Singapore

Lecturer Vascular & Interventional Radiology, KEM Hospital, Mumbai.

Neuroradiology, AIIMS, New Delhi.

Mobile 098104 92778 or E-mail at muleypradeep@hotmail.com

Website http://www.indianinterventionalradiology.in

Fibroid Embolization and Fertility

Fibroid Embolization Shows Fertility Rates Comparable to Myomectomy

 First Global Study Indicates Comparable Fertility Rates for Minimally Invasive UFE and “Gold Standard” Surgical Myomectomy for Women Who Want to Have Children After Uterine Fibroid Treatment.

TAMPA, Fla. (March 15, 2010)—Uterine fibroid embolization, a minimally invasive interventional radiology procedure that blocks blood supply to treat painful uterine fibroids, has a comparable fertility rate to myomectomy, the surgical removal of uterine fibroids, for women who want to conceive, according to the first study on the subject released at the Society of Interventional Radiology’s 35th Annual Scientific

Meeting in Tampa, Fla.

“This study is significant because it shows comparable fertility rates between the two primary uterus-sparing treatments widely available to treat fibroids: uterine fibroid embolization (UFE) and surgical myomectomy, which is considered the gold standard for symptomatic fibroids in women who wish to conceive,” said João Martins Pisco, M.D., an interventional radiologist at St. Louis Hospital in Lisbon, Portugal. “These results are surprising because other studies have favored surgical myomectomy over UFE for women who want to conceive. In this study of 743 women, UFE had a fertility rate of 58.1 percent, which is comparable to surgical fibroid removal (myomectomy), which has a fertility rate of 57 percent,” noted Pisco. “Our study proves that UFE not only allows women who were unable to conceive to become pregnant but also allows them to have normal pregnancies with similar complication rates as the general population in spite of being a high risk group,” he added. “In the future, UFE will probably be a first-line treatment option even for women who wish to conceive and are unable due to the presence uterine fibroids,” he noted. Uterine fibroids are benign tumors in the uterus that can cause prolonged, heavy menstrual bleeding that can be severe enough to cause anemia or require transfusion, disabling pelvic pain and pressure, urinary frequency, pain during intercourse, miscarriage, interference with fertility and an abnormally large uterus resembling pregnancy. Twenty to 40 percent of American women 35 and older have uterine fibroids, and nearly 50 percent of premenopausal African American women have fibroids of a significant size.

An increasing number of women are delaying pregnancy until their late thirties, which is also the most likely time for fibroids to develop, said Pisco. There is conflicting evidence in the medical literature regarding the impact of fibroids on pregnancy; however, the risk and type of complication appear to be related to the size, number and location. Women may not know they have fibroids (asymptomatic) and undergo in vitro fertilization treatments—rather than getting treatment for fibroids. “We want women to know that uterine fibroids may be a cause of infertility, that their treatment is mandatory and that UFE may be the only effective treatment for some women,” said Pisco. The conventional treatment of uterine fibroids in patients who wish to become pregnant is myomectomy, which is surgical fibroid removal. This treatment is usually effective, particularly if the fibroids are in small number and of small or medium size. UFE, which has a lower complication rate than myomectomy, may be performed if a woman has many fibroids or large-sized fibroids and a gynecologist cannot rule out a hysterectomy (uterus removal) during myomectomy or if myomectomy is unsuccessful.

In the Portuguese study, most women opted for UFE as a fertility treatment after failure of myomectomy or in vitro fertilization or because hysterectomy was the only suggested option. Of the 743 patients who received UFE treatment, 74 wanted to conceive and had been unable. Of these 74 women, 43 or 58.1 percent (average age, 36.2) became pregnant; the time between UFE and conception ranged from 2 to 22 months. At this time, there have been 36 completed pregnancies, resulting in 30 births (83.3 percent); seven women are still pregnant. “Most of the pregnancies after uterine fibroid embolization had good outcomes with few complications. The complication rate of the pregnancies was expected to be higher than the general population because these were high-risk patients who had already undergone fertility treatments and were unable to conceive,” said Pisco. “However, the percentage of the spontaneous abortions (11.1 percent), preterm delivery (10.0 percent) and low birth weight (13.3 percent) was the same as the general population,” he stated.

Uterine fibroid embolization is performed by interventional radiologists. These physicians are trained to perform this and other types of embolization and minimally invasive targeted treatments. An interventional radiologist makes a tiny nick in the skin, about the size of a pencil tip, and inserts a catheter into the femoral artery. Using real-time imaging, the physician guides the catheter through the artery and then releases tiny particles, the size of a grain of sand, into the blood vessels feeding the fibroid, cutting off its blood flow and causing it to shrink and symptoms to subside. Most women return home the same day and can resume normal activities within two to five days afterwards.

Myomectomy is usually major surgery that involves cutting out the biggest fibroid or collection of fibroids and then stitching the uterus back together. Most women have multiple fibroids, and it is not physically possible to remove all the fibroids because it would remove too much of the uterus. While myomectomy is frequently successful in controlling symptoms, the more fibroids the patient has, generally, the less successful the surgery. In addition, fibroids may grow back. Because of this, myomectomy surgery often needs to be repeated. This was a small retrospective study based on patients being treated for fibroids by UFE in a single institution, said Pisco. He said that larger, multicentered, randomized prospective studies are needed

comparing UFE and myomectomy. More information about the Society of Interventional Radiology, interventional radiologists and uterine.

fibroid embolization or UFE can be found online at http://www.indianinterventionalradiology.in/club.htm

Treating Varicose vein without surgery

Treating Varicose vein without surgery

With New Radio Frequency Ablation (Multipolar RFA)

Comfortable and sedentary life-style, modern fashion, special postures adopted while performing professional duties has contributed to increased incidence of a set of diseases unheard of in the past. Varicose vein disease is one of them and is a direct result of sedentary life-style.

According to one estimate, 15 to 20 per cent of the population in India is suffering from varicose vein disease these days. Women suffer from this disease four times more than men. There is an increased risk of the development of varicose vein among young females who wear tight jeans and high-heeled sandals.

What is varicose vein and symptoms?

The leg vein normally contains multiple valves, which helps the blood flow in direction of the heart. When these valves are damaged, blood starts pooling in the legs causing swelling of the legs, aching pain, fatigue, skin discolouration, itching, varicosities and if not treated it may develops non-healing ulcersin leg. Ultimately, the person is forced to lead a disabled life. 

 The causes

The important factors are obesity, lack of exercise, abnormal pressure on veins during pregnancy, abnormal life-style, prolonged standing and prolonged sitting with legs down. Due to advanced age, overweight and lack of exercise veins of legs become very weak and, therefore, develop into varicose veins.

Today a lot of occupations and professions have sprung up where a person is required to either constantly stand up for a long time or made to sit with legs hanging down for a considerable time. Computer professionals, receptionists, security guards, traffic policemen, salesmen working at counters in shops and departmental stores and persons doing desk jobs day in and day out are the worst sufferers of varicose veins.

Why women are more susceptible to varicose veins?

Among females, due to some hormones, the walls of veins become enlarged and dilated. Besides, during pregnancy because of a lot of pressure on leg veins, these become weak and varicose. Fashion is playing havoc among women. High-heeled sandals and tight belts and panties are significant contributors to the development of varicose veins, as these items obstruct the normal flow of blood in the veins.

How long does the RFA procedure take?

The average time for the procedure is about 45 – 60 minutes. One can expect to be at the hospital for about two hour. 

Is RFA painful?

There is some mild pain during the procedure. However, prior to the procedure, the doctor will inject some local anesthetic to numb the area.

When can I return to normal activities?

It is highly recommended that you resume your activities the next day. Except for strenuous exercise or heavy lifting, most other activities can be resumed the next day. Sporting activities can usually be resumed in of 5-7 days.

 

Diagnosis of varicose veins

This is done by general examination and ultrasound Doppler study that can show the exact site of disease in the form of damaged valves & dilatation of veins.

Till now VARIOUS TREATMENT OPTIONS available for varicose veins were available like

A.      Elevating the legs while lying down or sitting, bending legs occasionally when standing for a long period of time.

B.   Compression Stockings.

C.   Sclerotherapy for short segment disease. 

D.   Vein Stripping Surgery is a major surgery where the recurrence rate is too high, cause ugly scar in legs and 2-3 weeks needed for recovery. 

E.  Laser ablation where the recurrence and other complication are higher as compare to RADIOFREQUENCY ABLATION.

Radio-frequency ablation (RFA)

RFA is the latest and most effective, patient friendly and non-surgical treatment for varicose vein using Multipolar RFA machine. Under color Doppler ultrasound vision, a radio frequency catheter is inserted into the abnormal vein and the vessel treated with radio-energy, resulting is closure of the involved vein.

The interventional radiologist (interventional radiologists are uniquely skilled in using the vascular system to deliver targeted treatments throughout the body without surgery) accesses the abnormal saphenous vein just above or below the knee percutaneously through a small cannula in abnormal vein. Ablation uses a thin, flexible tube called a catheter with tiny electrodes at the tip of the catheter, which heat the walls of the varicose vein, and collapses the thick veins. 

  

Benefits of Treatment with RFA

1.  RFA procedure needs no general anesthesia.
2. No scars or stitches – because the procedure does not require a surgical incision. 
3. Done as an outpatient / day care / one day procedure. 
4. No blood loss or risk of blood transfusion.
5. Makes faster recovery as compare to traditional treatment.
6. It is cheaper than traditional surgery. 
7. The recurrence rate is very low as compared to surgery. 
8. More accurate and safe because done under guidance by trained Interventional Radiologist.
9. RFA performed in cath suite (interventional radiology procedures room) by interventional radiologist.

What are side effects of the RFA procedure?

Some individuals may have mild bruising or swelling. This disappears in 10-14 days.

For more in-depth information contact :

Dr. Pradeep Muley M.D.

Head & Senior Consultant Interventional Radiologist

Fortis Hospital, Vasant Kunj, New Delhi, India

Fellow, Neurointerventional Radiology, John’s Hopkins Medical Institutions, USA

Visiting Associate, Neurointerventional Radiology, Iowa University, USA

Fellow Interventional Radiology, Singapore General Hospital, Singapore

Lecturer Vascular & Interventional Radiology, KEM Hospital, Mumbai.

Neuroradiology, AIIMS, New Delhi.

Mobile 098104 92778 or E-mail at muleypradeep@hotmail.com

Website http://www.indianinterventionalradiology.in

Non-surgical Treatment for Uterine Fibroid

Uterine Artery Embolization For

Uterine Fibroids & Adenomyosis

Uterine Artery Embolization has many Indications:-

·  Single / multiple Uterine Fibroids.

·  Adenomyosis.

·  Failed myomectomy / recurrence of fibroids after myomectomy

·  High risk patient for surgery like obesity, anaemia, Chronic renal failure etc .

·  Post-partum Hemorrhage

·  Bleeding from Cancer of Cervix & Uterus

·  Pre-operative embolization to reduce bleeding during uterine surgery.

Uterine Fibroids:Their symptoms and Treatment

Q. What are uterine fibroids?

A. Uterine fibroids are noncancerous (benign) growths that develops in the muscular wall of the uterus and these are the most frequent tumors of the female genital tract: 20 to 40% of women of childbearing age have a fibroid. Fibroids range in size from very tiny to the size of an orange or larger. In some cases, they can cause the uterus to grow to the size of a five-month pregnancy or more. Fibroid may be located in various parts of the uterus. There are three primary types of uterine fibroids: 

Subserosal fibroids, which develop in the outer portion of the uterus and expand outward. They typically do not affect women’s menstrual flow, but can become uncomfortable because of their size and the pressure they cause. 

Intramural fibroids, which develop within the uterine wall and expand, making the uterus feel larger than normal. These are the most common fibroids. These can result in heavier menstrual flow and lower abdominal pain or pressure. 

Submucosal fibroids are deep within the uterus, just under the lining of the uterine cavity. These are the least common fibroids, but they often cause symptoms, including very heavy and prolonged periods. 

Q. What are typical symptoms?

A. Depending on location, size and number of fibroids, they may cause:

·  Heavy, prolonged menstrual periods and unusual bleeding, sometime with clots. This might lead to anemia.

·  Lower abdomen, back or leg pain

·  Lower abdomen pressure or heaviness

·  Bladder pressure leading to a constant urge to urinate

·  Pressure on bowel, leading to constipation and bloating

·  Abnormally enlarged abdomen

Q. Who is most likely to have uterine fibroids?

A. Uterine fibroids are very common, although, often they are very small and cause no problem. From 20 to 40 % of women aged 35 and older have uterine fibroids of a significant size. 

Q. How are uterine fibroids diagnosed?

A. Fibroids are usually diagnosed during a gynecologic examination. The presence of fibroids is most often confirmed by a lower abdomen ultrasound. Fibroids can also be confirmed using MRI (magnetic resonance imaging) and computed tomography (CT scan). Appropriate treatment depends on the size and location of the fibroids, as well as the severity of symptoms.

Q. How are uterine fibroids treated?

A. Treatment options for uterine fibroids:

1.      Medical Management.

2.      Minimally Invasive Therapy (Uterine artery or fibroid embolization) and

3.      Surgical Management

1.      Medical Management 

Effective medical therapy is not available for management of fibroids. However hormonal drugs in the form of injections have recently become available which are expensive (GnRH analogue) this hormonal therapy cannot be used for long term basis because of its side effects. Also rapid regrowth of fibroids can occur when therapy is discontinued. 

2. Minimally invasive therapy (Uterine Artery (or fibroid) embolization 

This minimally invasive procedure will be explored further in this brochure. Briefly, an interventional radiologist makes a tiny incision in the groin and passes a small tube called catheter through the artery. When the catheter reaches the uterine artery, the interventional radiologist slowly releases tiny particles, the size of grains of sand, into the vessels. The particles flow to the fibroids and wedge into the vessels and cannot travel to other parts of the body. This blocks the blood flow to the fibroids, causing it to shrink.

Q. What is fibroid embolization?

A. It is a minimally invasive procedure, which means it requires only a tiny nick in the skin. It is performed while the patient is conscious but sedated – drowsy and feeling no pain. 

Fibroid embolization is performed by an interventional radiologist, a physician who is specially trained to perform this and other minimally invasive procedures. The interventional radiologist makes a small nick in the skin (less then ¼ of an inch) in the groin and inserts a catheter into an artery. The catheter is guided through the artery to the uterus while the interventional radiologist guide the progress of the procedure using a moving X-ray (fluroscopy). The interventional radiologist injects tiny plastic particles the size of grains of sand into the artery that is supplying blood to the fibroid tumor. This cuts off the blood flow and causes the tumor (or tumors) to shrink. The artery on the other side of the uterus is then treated. 

  Embolization preparation. A tiny angiographic catheter is inserted through a nick in the skin in to an artery and advanced into uterus. A.      Injection. Tiny polyvinyl alcohol particles of 500 um in diameter are wedge in the small arteries, blocking the blood flow to the fibroids.

While embolization to treat uterine fibroids has been performed since 1995, embolization of the uterus is not new. It has been used successfully by interventional radiologist for over 20 years to treat heavy bleeding after childbirth. This procedure is now available at few hospitals. 

Q. Which patient can go for fibroid embolization?

A. Ideal Patient for uterine artery embolization.

1.   They have single / multiple fibroids

2.  The fibroids are symptomatic.

3.  There is no cancer (as suggested by pap smear or endometrial biopsy)

Q. What are the benefits of fibroid embolization? (Minimally invasive procedure)

A. The benefits are:

1.      It is performed under Local anesthesia. Not General anesthesia.

2.      Requires only a tiny nick in the skin (No surgical incision of abdomen).

3.      Recovery is shorter than from hysterectomy or open myomectomy. Within 3 days patient can attend the job.

4.      Virtually no adhesion formation has been found. But in surgery adhesions are common.

5.      All fibroids are treated at once, which is not the case with myomectomy.

6.      There has been no observed recurrent growth of treated fibroids in the past 9 years.

7.      Uterine fibroid embolization involves virtually no blood loss or risk of blood transfusion.

8.      Many women resume light activities in a few days and the majority of women are able to return to normal activities (including exercise) within a week.

9.   If the presenting complaint was excess vaginal bleeding, 87-90% of cases experience resolution within 24 hours.

10. Emotionally, financially and physically – embolization can have an overall advantage over other procedures for the patient, as the uterus is not removed.

Q. How successful is the fibroid embolization procedure?

A. Studies show that 94-98% of women who have the procedure experience significant or total relief of heavy bleeding, pain and other symptoms. The procedure also is effective for multiple fibroids. No regrowth of treated fibroids is observed. 

Q. Are there risks associated with the treatment of fibroid tumors?

A. Fibroid embolization is considered a safe alternative to hysterectomy and myomectomy. 

There are some associated risks, as there are with almost any medical procedure. Most women experience moderate pain, nausea and fever. These symptoms can be controlled with antibiotics and pain medication. Less then 1% of the patient need myomectomy or hysterectomy to complete the removal of a persisting fibroid. 

Myomectomy and hysterectomy also carry risks, including infection, bleeding leads to blood transfusion. Patients who undergo myomectomy may develop adhesions causing tissue and organs in abdomen to fuse together, which can lead to other problems. In addition, the recovery time is much longer for abdominal myomectomy, generally one to two months. 

3. (Surgical option) Myomectomy Myomectomy is a surgical procedure that removes visible fibroids from the uterine wall. Myomectomy, like uterine artery embolization for fibroids, leaves the uterus in place and may, therefore, preserve the women’s ability to have children. There are several way to perform myomectomy, including hysteroscopic myomectomy, laparoscopic myomectomy and open abdominal myomectomy: 

     Hysteroscopic Myomectomy: It is used only for fibroids that are just under the lining of the uterus and that protrude into the uterine cavity (submucosal fibroid). There is no need for surgical incision. The doctor inserts a flexible scope (hysteroscope) into the uterus through the vagina and cervix and removes the fibroids using surgical tools fitted to the scope. Usually this procedure is performed while the patient is under anesthesia and not conscious. The hospital stay is about 2 days, the postoperative recovery period of two weeks, needs general anesthesia, some time causes bleeding which may need blood transfusion and chances of infection are also there. Removal of big size fibroid is difficult which may need 2-3 sittings. 

     Laparoscopic Myomectomy: Laparoscopic myomectomy may be used if the fibroid is on the outer wall of the uterus. Small incisions are made on the abdomen and then a probe is inserted with a tiny camera attached and another probe fitted with surgical instruments, into the abdominal cavity and tumor is removed piecemeal. It is performed while the patient is under general anesthesia and not conscious. The average recovery time is about two weeks. Some time cause bleeding which may need blood transfusion and chances of infection may also be there. 

     Abdominal Myomectomy: This is an open abdominal surgery to remove fibroids. It needs 2-3 incision on abdomen. Once the fibroids are removed, the uterus is stitched and closed. The patient is given general anesthesia and not conscious for this procedure, the hospital stay is 4-5 days and postoperative recovery period is six weeks. Some times procedure causes bleeding which may need blood transfusion, adhesions may cause problem. Regrowth rate of fibroids is high. 

While myomectomy is frequently successful in controlling symptoms, it is not successful in case of multiple fibroids.. In addition, fibroids may grow back several months/ years after myomectomy 

Hysterectomy. 

In hysterectomy (Vaginal or Abdominal), the uterus is removed by an open surgical procedure. This operation is considered a major surgery and is performed while the patient is under general anesthesia. It requires four to five days of hospitalization and the average recovery period is about six weeks. 

Hysterectomy is the most common current therapy for women who have fibroid. It is typically performed in women who have completed their childbearing years or who understand that after the procedure, they cannot become pregnant. 

This blog-page was created to answer frequently asked questions about uterine fibroids. The page contains general information about this common condition, as well details about procedures performed by interventional radiologists to treat uterine fibroids. 

For more in-depth information on fibroids embolization contact muleypradeep@hotmail.com or call at mobile +91-98104 92778. 

Dr. Pradeep Muley M.D.
Head & Senior Consultant Interventional Radiologist

Fortis Hospital, vasant Kunj, New Delhi, INDIA
Fellow, Neurointerventional Radiology, John’s Hopkins Medical Institutions, USA
Visiting Associate, Neurointerventional Radiology, Iowa University, USA
Fellow Interventional Radiology, Singapore General Hospital, Singapore
Lecturer Vascular & Interventional Radiology, KEM Hospital, Mumbai.
Neuroradiology, AIIMS, New Delhi.

Mobile 098104 92778 or E-mail at muleypradeep@hotmail.com
Website http://www.indianinterventionalradiology.in/