Digital imaging of background erasure and endometrial coherence node in the myometrium

Endometriosis is one of the common causes of infertility. An estimated 5-10% of women of reproductive age are affected by the disease. Endometrial coherence node method is currently commonly used due to its minimally invasive nature, safety and high treatment efficacy.

Endometriosis (Adenomyosis) is a condition in which endometrial tissue, which is located in the opening of the uterus, is present outside the uterine cavity, causing symptoms of menstrual pain, prolonged menorrhagia, dull pain in the lower part of the uterus. taste, affecting the life and fertility of many patients.
There are many treatment modalities for endometriosis such as:
Drug treatment Interventional surgery Treatment with endometriotic node in the myometrium Each treatment method has its own advantages and disadvantages. While the indications for emergency surgery for internal injuries have many potential risks such as bleeding, wound infection, prolonged recovery time... the endometrial coherence node has the following advantages:
Maximum preservation of damaged visceral area; Short technical implementation time: about 45 minutes; The incision of the interventional instrument is small, so it does not leave scars and does not cause bleeding; Reducing the risk of complications and complications compared to major major surgeries; The patient is awake and recovers quickly (can be discharged from the hospital 1-2 days after the intervention)

Indication cases:
In case of endometriosis causing abdominal pain and prolonged menorrhagia, the pain and hormonal treatment is ineffective and there is no indication for surgical treatment. Endometriosis in women with a need to maximize the preservation of the uterus for childbirth or improving quality of life. People with endometriosis with normal blood tests, coagulation function, liver and kidney function, and normal vaginal cells. Contraindications:
Patients with infectious diseases; Patients with kidney failure, severe liver failure; Diabetic patients ; People who are sensitive or allergic to iodine-containing products; People with a history of bronchial asthma; People who are pregnant; The patient has appendicitis and suspected malignancy of the uterus and cervix.

To perform a digital scan to erase the background and endometrial coherence node in the myometrium, it is necessary to prepare:
Implementation team:
Radiology specialist, ancillary doctor; Electro-optical technician; Anesthesiologist/technologist (if patient is difficult to cooperate); Nursing. Means of use:
Digital background eraser (DSA); Film, film printers and image storage systems; Dedicated electric pump; Lead vest, apron to help shield from X-rays. Drugs:
Local anesthetics General anesthetics; Water-soluble iodinated contrast agent; Anticoagulants and anticoagulant neutralizers; Antiseptic solution for skin and mucous membranes. General medical supplies:
1,3,5,10ml syringe and pump for electric pump. Distilled water (physiological saline); Medicine box and accident first aid box. Surgical clothing; Sterile kit (scissors, knife, tongs, tool tray, etc.); Cotton gauze, surgical medical adhesive tape. Special medical supplies:
Needle puncture; Standard conductor 0.035inch; Set of 5-6F intravascular inlet tubes; Microcatheter 2-3F, microwire 0.014-0.018inch; 4-5F angiography catheter, 6F guide catheter Y-connector set. Embolization material:
Bio-foam to help stop bleeding; Synthetic resin (PVA); Bio-adhesives (Histoacryl, Onyx...); Metal coils (coils) of all sizes.
The patient needs to prepare:
The procedure is explained carefully to coordinate with the doctor; Clinical examination before the procedure; Fasting, drinking before 6 hours, avoid drinking more than 50ml of water; If the patient cannot lie still, sedation will be prescribed.

Steps to perform a digital scan to erase the background and endometrial coherence node:
In the intervention room, the patient is instructed to lie on his back. The doctor placed a bladder catheter, placed an intravenous line, placed a breathing monitor, electrocardiogram, pulse, blood pressure, measured peripheral blood oxygen saturation to monitor vital functions. The nurse disinfects the inguinal area on both sides and spreads sterile gauze and sheets on the patient. Anesthetize the common femoral artery about 1cm below the inguinal fold. Make an incision in the skin and insert a needle into the artery. Push the catheter and catheter into the femoral artery. Under the guidance of the DSA background scan, insert the catheter into the uterine artery and take an examination. If satisfactory, PVA resin is injected with contrast agent until the tumor is permanently blocked. stop. Take a DSA check again. Withdraw the catheter, insert it into the contralateral uterine artery and do the same. Withdraw the catheter and tube into the lumen, and apply pressure to the puncture site. After the procedure, the patient lies motionless for about 6-8 hours, then the compression bandage can be removed. After the endometrial junction in the myometrium, the patient should take antibiotics to avoid infection. Patients only need to stay in the hospital for 1-2 days before being discharged.

Technique of endometrial coherence endometrium is assessed to be quite safe and almost no serious complications occur. Risky complications such as tumor rupture, hematuria were completely controlled because the renal organs were kept intact. Some other common complications of angiography such as bleeding, hematoma at the puncture site... may be present but rarely occur. In general, intrauterine endometrial junction is considered an effective choice in the treatment of large or complicated renal vascular lipomas.
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