Pre-operative embolization of meningiomas is commonly performed in the USA, but rarely in the UK and Europe. It is not always necessary, as the feeding arteries to many tumors can be dealt with at surgical approach. Most convexity meningiomas are vascular, whilst many skull base meningiomas are relatively avascular.
Embolization in selected cases is undoubtedly very beneficial, reducing pre-operative bleeding and allowing better tumor control. Devascular-ized cases usually have less need for blood transfusion than unembolized cases .
Embolization is carried out using PVA particles to the tumor bed, using progressively larger particles of 50-150 ^ followed by 150-250 Care should be taken to look for hidden anastomoses. The main distal feeding vessel can then be occluded by coils.
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.