All are methods of managing fibroid uterus. Except :
Ans. is b i.e. Radiofrequency ablation Emblotherapy : Uterine aery embolization is done using polyvinyldeg alcohol or gel foamdeg, in patients not suited for or not desirous of surgical therapy. Uterine blood flow is obstructed producing ischemia and necrosis. It shrinks the fibroid by 40-50% in selective young women.deg Results : These patients experience lowered feility ratedeg risk of placental insufficiency anddeg uterine rupture in subsequent pregnancydeg because of interference with the blood supply and embolotherapy induced necrosis of the leiomyoma. Due to lack of long term outcome data women who desire future childbearing are not currently considered candiates for uterine aery embolisation Post op Complications : * Paindeg Feverdeg Pulmonary embolismdeg Complete amenorrheadeg Extra Edge Indications for operating an Asymptomatic fibroiddeg : Fibroids larger than 12-14 weeks pregnancy.deg Rapidly growing fibroids.deg Subserous and pedunculated fibroid prone to torsion.deg If it is likely to complicate a future pregnancydeg If there is doubt about its naturedeg Unexplained infeility and unexplained recurrent aboion.deg Unceain diagnosis.deg Indications of Medical managementdeg : To treat anemia and recover Hb levels before surgery.deg To reduce the size of large fibroid and facilitate surgery.deg Treatment of women approaching menopause to avoid surgery.deg In women with medical contraindication to surgery or those who are postponing surgery.deg For Preservation of feility in women with large myomas before conservative surgery like myomectomy.deg Indications of surgical managementdeg : Fibroids causing symptoms like Menorrhagiadeg Pressure symptomsdeg : Urinary Retention (by a cervical or broad ligament fibroid) Chronic pelvic pain withdeg severe dysmenorhea Acute pelvic pain as indeg torsion of a pedunculated fibroid or prolapsing Sub-mucosal fibroid Infeility caused by cornual fibroid Recurrent aboions due to submucous fibroid.
Myomectomy
Radio frequency ablation
Embolisation of uterine aery
Laser myomectomy