الفهرس 
introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
Uterine artery embolization has been used to treat a number of hemorrhagic gynecologic problems, including bleeding in cancer, in post partum and post surgical bleeding. Also it represents an exciting, promising, and minimally invasive new option for patients with symptomatic fibroid disease. In our study which included 18 patients with abnormal uterine bleeding due to different causes, angiography was performed on 36 uterine arteries. Twenty seven uterine arteries and three anterior divisions of the internal iliac artery have been embolized. Bilateral uterine artery embolization was carried out for 11 patients (22 uterine arteries) while unilateral uterine artery embolization was done for 5 patients (5 uterine arteries). Embolization of the anterior division of the internal iliac artery was conducted on 2 patients (unilateral for one patient and bilateral for the other women). Pre-embolization assessment and follow up after embolization were carried out for all patients using different imaging techniques. The clinical aspect including; history taking was a main method for follow up depending on the questionnaire about the improvement of bleeding. From our work, we concluded that both uterine arteries should be embolized for better results. Bilateral embolization can be done through contralateral femoral approach in one or two consecutive settings. Also, it can be performed through a single femoral puncture. The technique should be carried out under local anaesthesia at the puncture site. 5 F cobra head catheter is the routinely used catheter for superselective catheterization of the uterine artery unless there is arterial spasm where 3 F coaxial microcatheter can be used. Different embolic agents can be used for UAE including; microcoils, PVA, gelatin particles, Embosphere microphere particle or combination of any of them. There is no significant difference in using any of these agents. There is marked reduction of bleeding and improvement of the bulk related symptoms after UAE. There is also, reduction of uterine and fibroid size and vascularity on follow up by different imaging techniques. UAE has high success rate in comparison with the standard uterine sparing surgery with a shorter post procedural recovery period and lower morbidity and mortality rates. Major complications of UAE are rare compared with other surgical procedures. Minor complications are usually encountered. The most common complication is post embolization syndrome which is transient and usually disappears within one week. Advantages of this method of treatment include; avoidance of surgery and its risks, rapid recovery, and a low complication rate. UFE has several potential advantages over hysterectomy, myomectomy and hormonal suppression. Unlike myomectomy or hysterectomy, UFE involves virtually no blood loss or risk of blood transfusion. General anesthesia and surgical incisions are avoided. Recovery is weeks shorter than recovery from hysterectomy or open myomectomy. Also early menopause-like symptoms are rarely induced as a result of UFE, as are often seen with gonadotropin-releasing hormone (GnRh) therapy. In multiple uterine fibroid, all fibroids are treated at once, which is not the case with myomectomy. UFE recurrence rates appear to be lower than those of myomectomy. Lastly, UAE is a minimally invasive short (1 hour), safe and effective method for treating abnormal uterine bleeding due to different causes with uterine preservation for further fertility.