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International Journal of Gynecology and Obstetrics (2005× 89, 305 318 www.elsevier.com×locate×Iago SGC CLINICAL PRACTICE GUIDELINES Uterine fibroid embolization (UFE) Number 150, October 2004 Abstract

How to fill out successful bilateral uterine artery

Point by point, here's how to fill out a successful bilateral uterine artery:

1. Start by familiarizing yourself with the anatomy of the uterine artery. Understand its location, branches, and its role in the reproductive system.
2. Begin the procedure by properly positioning the patient. The patient may be placed in the lithotomy position with their legs in stirrups, allowing access to the pelvic area.
3. Ensure that the patient is adequately sedated or anesthetized, depending on the specific procedure. This ensures their comfort and minimizes any potential pain or discomfort.
4. Cleanse and sterilize the abdominal and pelvic areas to minimize the risk of infection. Use an antiseptic solution following standard protocols.
5. Create a small incision over the lower abdomen using a scalpel. This will provide access for the necessary instruments and visualization of the uterine artery.
6. Identify the uterine artery by visually inspecting the surrounding tissue. It is usually located near the cervix and may be identified by its pulsation and size. Use gentle palpation to confirm its presence.
7. Carefully dissect the tissue surrounding the uterine artery to expose it adequately. Use caution to avoid damaging any nearby structures such as the bladder or bowel.
8. Once the uterine artery is properly exposed, use appropriate clamps or vessel loops to achieve temporary occlusion. This helps in controlling the bleeding during the procedure.
9. With the artery occluded, carefully divide or ligate the artery as needed. Ensure proper hemostasis to prevent excessive bleeding. Depending on the specific situation, the level and extent of the occlusion may vary.
10. After completing the procedure on one side, repeat steps 6 to 9 on the opposite side to achieve bilateral occlusion. Take necessary precautions to avoid injury and ensure a successful outcome.

Who needs successful bilateral uterine artery?

1. Patients with symptomatic uterine fibroids: Successful bilateral uterine artery embolization is commonly performed in patients with symptomatic uterine fibroids. This non-surgical procedure aims to block the blood supply to the fibroids, leading to their shrinkage and alleviating symptoms such as heavy menstrual bleeding, pelvic pain, and pressure symptoms.
2. Women with postpartum hemorrhage: In cases of severe postpartum hemorrhage, when conservative methods fail, bilateral uterine artery occlusion may be necessary to control the bleeding. It can be a life-saving procedure to prevent excessive blood loss and its complications.
3. Individuals with certain gynecological malignancies: In some cases of gynecological cancers, such as cervical or endometrial cancer, removing or occluding the uterine artery may be part of the treatment plan. This can help prevent the spread of cancer or control bleeding during surgical interventions.

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