Investigating the effect of uterine artery embolisation on the uterus of women with fibroids and heavy menstrual bleeding

Hamoodi, Ibraheem (2017) Investigating the effect of uterine artery embolisation on the uterus of women with fibroids and heavy menstrual bleeding. MD thesis, University of Glasgow.

Abstract

Uterine fibroids are common benign tumours in women. The effect they have can range from pressure symptoms and heavy menstrual bleeding to denying a woman a successful pregnancy. Despite the overall benign classification of fibroid, it is undeniable that the reduced quality of life these tumours cause may exceed the effect that some early stage gynecological cancers have on a suffering woman. There has been extensive research into treatments for fibroids however this has only resulted in a handful of worthy advances which are not proportionate to the impact these “benign” tumours have on a suffering woman. The mechanism for how fibroids affect the endometrium and cause heavy menstrual bleeding is understudied. Some of this research has pointed towards vascular endothelial growth factor and cyclooxygenase as potential mediators that change the perceived heaviness –amount and length- of a menstrual period in a woman with fibroids.
Uterine artery embolisation (UAE) has emerged as a lesser invasive option and an alternative to surgery. The reported high technical success of the procedure independent of BMI and the short hospital stay and quick recovery has made it an attractive treatment modality. However, the mechanism of how it works is still not understood. Women with large variation in uterine size and fibroid number and size are undergoing this procedure without the full knowledge of how they will individually respond.
This thesis aims to explore the mechanism of how UAE works by looking at the change in expression of VEGF, COX-2 & Ki67 and also the change in microvascular density of the endometrium post UAE. Our aim was to investigate how women with different sized fibroid uteri would respond to UAE and if DWI MRI had any advantages above standard MRI in predicting the outcome of UAE.

• Item Type: Thesis (MD)
• Qualification Level: Doctoral
• Keywords: Uterine fibroids, uterine artery embolisation, heavy menstrual bleeding.
• Subjects: R Medicine > RG Gynecology and obstetrics
• Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Supervisor's Name: Lumsden, Professor Mary Ann
• Date of Award: 2017
• Depositing User: Dr Ibraheem Hamoodi
• Unique ID: glathesis:2017-8114
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 04 May 2017 13:36
• Last Modified: 22 May 2017 10:34
• URI: https://theses.gla.ac.uk/id/eprint/8114