Abstract
Background
The goal of this study was to evaluate the effects of laparoscopic coagulation or blockage of the uterine arteries and myomectomy in treating symptomatic myomas.
Methods
A total of 142 women with symptomatic fibroids warranting surgical treatment and wanting to retain their uteri were treated by laparoscopic coagulation or blocking of the uterine arteries and myomectomy.
Results
Most of the 142 patients had multi-myomas of the uterus, as intramural myomas (54), subserous myomas (65), and submucosal myomas (25). The number of myomas in each patient varied from 1 to 4. The size of the myomas in all patients ranged from 2 to 12 cm. In 86 cases (60.4%) the uterine wall was sutured in one layer. Average operating time was 124.2 ± 33.1 min, and average blood loss was 117.8 ± 48.6 ml. Mean postoperative hospital stay was 4.8 ± 1.2 days. All patients underwent technically successful laparoscopic coagulation or blocking of uterine arteries and myomectomy without intraoperative complications. The mean follow-up time was 16.2 months (16–26). Symptomatic improvement was achieved in all patients. Five patients experienced recurrence of myomas.
Conclusions
Laparoscopic coagulation or block of the uterine arteries and myomectomy appears to be a safe, effective, and promising new method for treating symptomatic uterine myomas.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bum PR, Me Call JM, Chinn RJ (1999) Uterine fibroleiomyoma: MR imaging appearances before and after embolization of uterine arteries. Radiology 214: 729–734
Burbank F, Hutchins FL (2000) Uterine artery occlusion by embolization or surgery for the treatment of fibroids: a unifying hypothesis—transient uterine ischemia. J Am Assoc Gynecol Laparosc 7 (4 Suppl): S1–S49
Buttram VC Jr, Reiter RC (1981) Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril 36: 433–445
Daniel JF, Gurtey LD (1991) Laparoscopic treatment of clinically significant symptomatic uterine myomas. J Gynecol Surg 7: 37
Dubuisson JB, Fauconnier A, Fourchotte V, Babaki-Fard K, Coste J, Chapron C (2001) Laparoscopic myomectomy: predicting the risk of conversion to an open procedure. Hum Reprod 16: 1726–1731
Dubuisson JB, Lecuru F, Foulot H, Fauconnier A, Babaki-Fard K (1991) Myomectomy by laparoscopy: a preliminary report of 43 cases. Fertil Steril 56: 827–830
Emanuel MH, Wamsteker K, Hart AA, Metz G, Lammes FB (1999) Long-term results of hysteroscopic myomectomy for abnormal uterine bleeding. Obstet Gynecol 93(5 Pt 1): 743–748
Fedele L, Parazzini F, Luchini L, Mezzopane R, Tozzi L, Villa L (1995) Recurrence of myomas after myomectomy: a transvaginal ultrasonographic study. Hum Reprod 10: 1795–1796
Garcia CR, Tureck RW (1984) Submucosal leiomyomas and infertility. Fertil Steril 42: 16–19
Godfrey CD, Zbella EA (2001) Uterine necrosis after uterine artery embolization for leiomyoma. Obstet Gynecol 98(5 Pt 2): 950–952
Hasson JM, Rotman C, Rana N, Sistos F, Dmowski WP (1992) Laparoscopic myomectomy. Obstet Gynecol 80: 884–888
Liu WM, Ng HT, Wu YC, Yen YK, Yuan CC (2001) Laparoscopic bipolar coagulation of uterine vessels: a new method for treating symptomatic myomas. Fertil Steril 75: 417–422
Liu WM, Tzeng CR, Yi-Jen C, Wang PH (2004) Combining the uterine depletion procedure and myomectomy may be useful for treating symptomatic fibroids. Fertil Steril 82: 205–210
Nezhat F, Seidman DS, Nezhat C, Nezhat CH (1996) Laparoscopic myomectomy today. Why, when and for whom? Hum Reprod 11: 933–934
Oktem O, Gokaslan H, Durmusoglu F (2001) Spontaneous uterine rupture in pregnancy 8 years after laparoscopic myomectomy. J Am Assoc Gynecol Laparosc 8: 618–621
Ravina JH, Herbreteau D, Ciraru-Vigneron N, Bouret JM, Houdart E, Aymard A, Merland JJ (1995) Arterial embolization to treat uterine myomata. Lancet 346: 671–672
Semm K, Mettler L (1980) Technical progress in pelvic surgery via operative laparoscopy. Am J Obstet Gynecol 138: 121–127
Seinera P, Arisio R, Decko A, Farina C, Crana F (1997) Laparoscopic myomectomy: indications, surgical technique and complications. Hum Reprod 12: 1927–1930
Shashoua AR, Stringer NH, Pearlman JB, Behmaram B, Stringer EA (2002) Ischemic uterine rupture and hysterectomy 3 months after uterine artery embolization. J Am Assoc Gynecol Laparosc. 9: 217–20
Sirjusingh A, Bassaw B, Roopnarinesingh S (1994) The results of abdominal myomectomy. West Indian Med J 43:138–139
Stewart EA (2001) Uterine fibroids. Lancet 357: 293–298
Vessey MP, Villard-Mackintosh L, McPherson K, Coulter A, Yeates D (1992) The epidemiology of hysterectomy: findings in a large cohort study. Br J Obstet Gynaecol 99: 402–407
Watson GM, Walker WJ (2002) Uterine artery embolisation for the treatment of symptomatic myomas in 114 women: reduction in size of the myomas and women’s views of the success of the treatment. Br J Obstet Gynaecol 109: 129–135
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Liang, Z., Xu, H., Chen, Y. et al. Laparoscopic blockage of uterine artery and myomectomy. Surg Endosc 20, 983–986 (2006). https://doi.org/10.1007/s00464-005-0643-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-005-0643-2