Uterine arteries embolisation: palliative treatment for acute vaginal bleeding in late stages of gynecologic malignancies

Uterine arteries embolisation (UAE) has been used as a minimally invasive interventional procedure and it addresses patients with benign or malignant uterine diseases. This technique had good results in case of patients presenting to the hospital for massive hemorrhage. Cervical cancer and endometrial cancer in advanced stages or after surgery are the mainly gynecological neoplasias which can be complicated with bleeding and could benefit from UAE. This study extends over a period of 5 years and includes 605 patients admitted to the Bucharest Emergency University Hospital's Obstetrics and Gynecology Department for acute vaginal hemorrhage and secondary anemia. Of these, 33 patients (5,45%) benefited from UAE. Endometrial cancer was diagnosed in 2 patients and cervical cancer was diagnosed in 31 patients. Used as a palliative treatment, UAE led to the remission of bleeding in up to 100% of cases and it allowed the correction of anemia. The evaluated group had an average age of 48,7 ± 8.3 years and the average duration of hospitalisation was 4.72 ± 2.97 days. The procedure has in general minimal side effects such as nausea and pain which can be easily controlled with common pain killers and antiemetics. Surgical ligation should be avoided when UAE is available due to the co-morbidities and complications associated with advanced stages of these malignant pathologies. The study also emphasises the necessity of interventional radiology departments in all regional emergency centres.