In Reply to: Re: Case 497_03 -- Embolization of uterine fibroids posted by Rob Kirsch on April 27, 1997 at 14:37:04:
I recently performed my first fibroid embolization for symptomatic fibroids with spectacular results. The patient is now experiencing normal menstruation for the first time in six years. In addition, she did not experience the post-embo syndrome described in most reports.
However I recently also performed emergency Gelfoam embo on a post partum bleeder who had a single large fibroid apparently preventing complete post partum uterine contraction. I was able to knock out the left uterine artery selectively but had to "settle" for the anterior trunk of the right internal iliac. Her bleeding immediately stopped and she went home shortly thereafter, only to return about a month later with a large necrotic and pus filled fibroid that required hysterectomy! Anyone else with a similar experience? I was surprised by this outcome, especially since this was a embo with large hand-cut Gelfoam pledgets. As this was a lifesaving procedure, I still consider it completely indicated, but does this have an implication for cases of non-urgent fibroid embo? Should we be measuring fibroids before we embo them? Are there proven protocols for prolonged antibiotics after these procedures?