Preface

One of the curious facts regarding the emergence of uterine artery embolization (UAE) in 1996 as a significant minimally invasive interventional radiological treatment for the common condition of fibroid disease was that the technique was led and championed by Dr. Jacques Ravina, a Parisian gynaecologist and that the radiological expertise was supplied by a team of neuroradiologists. After early concerns by the gynaecological community, UAE has become widely accepted and practiced and is now regarded in most countries as a significant treatment option for fibroid disease. Though there have been some technical refinements the embolization technique has remained largely unchanged but what has changed is the clinical evaluation, assessment, and overall management of these cases. Myomectomy as the surgical uterus-conserving alternative to UAE, perhaps spurred by the uptake of UAE has also undergone developments. This textbook in addition to giving state of the art accounts of many clinical aspects of fibroid embolization has also reviewed current myomectomy techniques and practice. Gynaecologists and interventional radiologists when discussing treatment options with women need to have a working knowledge of the alternative treatment options in order to make the optimal treatment decision. Thus, in this textbook the UAE chapters will give gynaecologists a working knowledge of fibroid embolization whilst similarly the myomectomy chapters will be of value to the interventional radiologist. Though UAE for fibroids is the most commonly performed vascular intervention in Obstetrics and Gynaecology less common vascular interventions are also covered. We are very grateful to Dr. Jacques Ravina who in his retirement has written a foreward detailing how he came about to pioneer this procedure and of the early days.