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  • Original Article

    Impact of the myoma arterial embolization by uterine volume, diameter myoma greater and in the ovarian function

    Rev Bras Ginecol Obstet. 2011;33(8):201-206

    Summary

    Original Article

    Impact of the myoma arterial embolization by uterine volume, diameter myoma greater and in the ovarian function

    Rev Bras Ginecol Obstet. 2011;33(8):201-206

    DOI 10.1590/S0100-72032011000800006

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    PURPOSE: To evaluate the impact of uterine artery embolization (UAE) on uterine volume (UV), greater myoma diameter (GMD) and ovarian function three months after the procedure, by transvaginal pelvic ultrasonography (TVPUS) and by the determination of follicle-stimulating hormone (FSH). METHODS: Thirty patients with leiomyomas were submitted to UAE. TVPUS and FSH determination were performed before and three months after UAE. UV was determined in cm³, GMD in cm and FSH in IU/mL. Data are reported as as mean standard deviation (SD) and were analyzed statistically by the nonparametric Mann-Whitney test. RESULTS: Twenty-nine patients were analyzed. Before UAE, mean UV was 402.4 165.9 cm³ and GMD was 5.9 2.1 cm. After UAE, mean UV was 258.9 118.6 cm³ and GMD was 4.6 1.8 cm. Mean FSH concentration was 4.9 3.5 IU/mL before UAE and 5.5 4.7 IU/mL after UAE, with p=0.5. There was a 35% reduction of UV and a 22% reduction of GMD, with no changes in FSH values after three months. CONCLUSION: The procedure significantly reduced UV and GMD but did not cause a significant increase in FSH levels, thus causing no changes in ovarian function.

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  • Original Article

    Uterine Fibroid Symptom – Quality of Life questionnaire translation and validation into Brazilian Portuguese

    Rev Bras Ginecol Obstet. 2016;38(10):518-523

    Summary

    Original Article

    Uterine Fibroid Symptom – Quality of Life questionnaire translation and validation into Brazilian Portuguese

    Rev Bras Ginecol Obstet. 2016;38(10):518-523

    DOI 10.1055/s-0036-1593833

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    Abstract

    Purpose

    To translate into Portuguese, culturally adapt and validate the Uterine Fibroid Symptom - Quality of Life (UFS-QoL) questionnaire for Brazilian women with uterine leiomyoma.

    Methods

    Initially, the UFS-QoL questionnaire was translated into Brazilian Portuguese in accordance with international standards, with subsequent cultural, structural, conceptual and semantic adaptations, so that patients were able to properly answer the questionnaire. Fifty patients with uterine leiomyoma and 19 patients without the disease, confirmed by abdominal pelvic examination and/or transvaginal ultrasound, were selected at the outpatient clinics of the Department of Gynecology of the Universidade Federal de São Paulo (Unifesp). The UFS-QoL questionnaire was administered to all women twice on the same day, with two different interviewers, with an interval of 15 minutes between interviews. After 15 days, the questionnaire was readministered by the first interviewer. Reliability (internal consistency and test-retest), construct and discriminative validity were tested to ratify the questionnaire.

    Results

    The reliability of the instrument was assessed by Cronbach’s α coefficient with an overall result of 0.97, indicating high reliability. The survey results showed a high correlation (p= 0.94; p 0.001).

    Conclusion

    The UFS-QoL questionnaire was successfully adapted to the Brazilian Portuguese language and Brazilian culture, showing reliability and validity.

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  • Original Article

    Pregnancy and delivery after arterial embolization for fibroid treatment

    Rev Bras Ginecol Obstet. 2006;28(10):596-600

    Summary

    Original Article

    Pregnancy and delivery after arterial embolization for fibroid treatment

    Rev Bras Ginecol Obstet. 2006;28(10):596-600

    DOI 10.1590/S0100-72032006001000005

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    PURPOSE: To analyze gestation evolution and deliveries after myoma treatment by embolization of the uterine arteries. METHODS: In the initial evaluation, 112 patients submitted to embolization of uterine arteries were included for treatment of myoma. From those, only nine wanted to be submitted to conservative treatment in order to keep their reproductive capacity. This procedure was indicated to the nine patients, since they were not susceptible to a conservative surgical treatment. They were submitted to embolization of the uterine arteries with particles of polyvinyl alcohol or embospheres with diameters ranging from 500 to 700 µm, and they have evolved without intercurrence. RESULTS: During the follow-up of these patients, there was a good clinical response with significant reduction in the uterus and myoma volumes. Four of them got pregnant, two had an early abortion and two evolved normally till the end of gestation with a term delivery. One of these had twins. CONCLUSION: Embolization of the uterine arteries is an option for the treatment of uterine myoma, and presents good clinical and anatomical results, allowing patients to preserve their reproductive capacity.

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  • Original Article

    Collagen histomorphometric evaluation in uterin tissue samples before and after treatment of uterine fibroids with arterial embolization

    Rev Bras Ginecol Obstet. 2009;31(12):598-603

    Summary

    Original Article

    Collagen histomorphometric evaluation in uterin tissue samples before and after treatment of uterine fibroids with arterial embolization

    Rev Bras Ginecol Obstet. 2009;31(12):598-603

    DOI 10.1590/S0100-72032009001200004

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    PURPOSE: to analyze histomorphometric consequences of the uterine arteries embolization (UAE) in the uterine tissue, especially by collagen tissue quantification through uterine biopsy, before and after treatment of uterine leiomyoma. METHODS: 15 patients with symptomatic leyomioma and/or infertility, submitted to UAE, participated in the study according to the study exclusion criteria, after having signed an informed consent. Uterine biopsy was performed in the secretory phase of the menstrual cycle, before and three months after the procedure, to evaluate the collagen. After the histological processing of the material, 3 µ slices were prepared, some of them dyed with hematoxiline-eosin (HE) and others with the specific dye for collagen fibers (Picrosirius red). Then, the slides were examined and interpreted, and the collagen quantified. The amount was calculated as the percent of the area composed by collagen, and the result expressed in mean±standard deviation (SD). Data has then been submitted to statistical analysis by Student's paired t test (p<0.05). RESULTS: the presence of smooth muscle cells was observed in the biopsies performed before the treatment, surrounded by a rich network of collagen fibers, which are part of the tumor, blood vessels and fibroblast nuclei. On the slides of biopsies performed after the treatment, it was observed the presence of widespread coagulation necrosis, vascular thrombosis, calcification and lymphoplasmocitary infiltration areas and clear reduction of the collagen component. The percentage of collagen fibers was higher in the pre-UAE group (84.07±1.41), than in the post-UAE (81.05±1.50) group, with p<0.0001, and 95% confidence interval (CI95%) from 2.080 to 3.827. CONCLUSION: the quantitative and qualitative collagen reduction clearly shows that the proposed treatment is efficient in reducing the tumoral mass, composed mainly by collagen fibers intermingled with neoplasic smooth muscle cells. Nevertheless, complementary studies are needed to investigate the functional and biological consequences of these histological changes.

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    Collagen histomorphometric evaluation in uterin tissue samples before and after treatment of uterine fibroids with arterial embolization

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