Validation of uterine artery embolization before surgical laparoscopic myomenucleation compared to single surgical laparoscopic myomenucleation for the treatment of large fibroids and uterus myomatosus.

Stefan Hertling, Ekkehard Schleu��ner, Lsabel Graul
Author Information
  1. Stefan Hertling: Department of Obstetrics, Jena University Hospital, Jena, Germany.
  2. Ekkehard Schleu��ner: Department of Obstetrics, Jena University Hospital, Jena, Germany.
  3. Lsabel Graul: Department of Orthopedics, Jena University Hospital, Eisenberg, Germany.

Abstract

Aim: To determine the efficacy of preoperative uterine artery embolization (uterine artery embolization; UAE) prior to elective laparoscopic fibroid removal compared to single laparoscopic fibroid removal in women with large uterine fibroids and women with uterus myomatosus.
Material and methods: A total of 202 women with symptomatic uterine fibroids who were scheduled for elective fibroid enucleation were included in this retrospective, monocentric, non-randomized study. Two procedures were compared: women who received percutaneous UAE 24 h prior to elective laparoscopic fibroid eviction for large uterine fibroids (>6 cm) and uterus myomatosus. And women who received laparoscopic fibroid enucleation alone for large uterine fibroids and uterus myomatosus. Outcome parameters for effectiveness were the hospital stay, the operating time and the intraoperative blood loss.
Results: Women who underwent preoperative percutaneous embolization of the uterine arteries, both for large fibroids and uterus myomatosus, had significantly less blood loss, shorter hospital stays, and shorter operating times.
Conclusions: Especially women with large uterine fibroids and women with uterus myomatosus after having children can benefit from the combination therapy of preoperative percutaneous uterine embolization with subsequent laparoscopic myoma enucleation.

Keywords

References

  1. Fertil Steril. 2023 Feb;119(2):333-335 [PMID: 36564265]
  2. Arch Gynecol Obstet. 2010 Apr;281(4):645-9 [PMID: 19536553]
  3. Am J Clin Pathol. 1990 Oct;94(4):435-8 [PMID: 2220671]
  4. Am J Obstet Gynecol. 2020 Aug;223(2):234.e1-234.e8 [PMID: 32087147]
  5. BMJ Clin Evid. 2015 Jun 02;2015: [PMID: 26032466]
  6. Rofo. 2012 Jan;184(1):48-52 [PMID: 22161234]
  7. Rofo. 2018 Jul;190(7):616-622 [PMID: 29514385]
  8. Rofo. 2017 Jun;189(6):508-510 [PMID: 28591884]
  9. Rofo. 2019 Jul;191(7):630-634 [PMID: 31137043]
  10. J Minim Invasive Gynecol. 2022 Nov;29(11):1219-1220 [PMID: 36038062]
  11. J Obstet Gynaecol Can. 2015 Feb;37(2):157-178 [PMID: 25767949]
  12. BJOG. 2004 Oct;111(10):1139-40 [PMID: 15383118]
  13. Cochrane Database Syst Rev. 2007 Jan 24;(1):CD005355 [PMID: 17253552]
  14. J Gynecol Surg. 2020 Apr 1;36(2):100-101 [PMID: 32293603]
  15. J Gynecol Obstet Hum Reprod. 2019 Jan;48(1):11-13 [PMID: 30267772]
  16. N Engl J Med. 2007 Jan 25;356(4):360-70 [PMID: 17251532]
  17. Rofo. 2013 May;185(5):461-3 [PMID: 23572203]
  18. Int J Gynecol Cancer. 2021 Jan;31(1):114-121 [PMID: 33158876]
  19. Int J Gynaecol Obstet. 2012 Feb;116(2):105-8 [PMID: 22098788]
  20. Eur J Radiol. 2011 Jul;79(1):1-6 [PMID: 19875261]
  21. Cureus. 2022 Nov 16;14(11):e31571 [PMID: 36540502]
  22. Rofo. 2017 Jun;189(6):511-514 [PMID: 28591885]
  23. J Minim Invasive Gynecol. 2015 Jul-Aug;22(5):820-6 [PMID: 25827327]
  24. Cardiovasc Intervent Radiol. 2008 May-Jun;31(3):514-20 [PMID: 17624572]
  25. Arch Gynecol Obstet. 2019 Dec;300(6):1719-1727 [PMID: 31677088]
  26. Geburtshilfe Frauenheilkd. 2012 Jun;72(6):539-542 [PMID: 25284842]

Word Cloud

Created with Highcharts 10.0.0uterinelaparoscopicfibroidsuteruswomenmyomatosusembolizationlargefibroidenucleationpreoperativearteryelectivepercutaneousUAEpriorremovalcomparedsinglereceivedhospitaloperatingbloodlossshortermyomasurgicalmyomenucleationAim:determineefficacyMaterialmethods:total202symptomaticscheduledincludedretrospectivemonocentricnon-randomizedstudyTwoprocedurescompared:24heviction>6cmaloneOutcomeparameterseffectivenessstaytimeintraoperativeResults:WomenunderwentarteriessignificantlylessstaystimesConclusions:EspeciallychildrencanbenefitcombinationtherapysubsequentValidationtreatmentbig

Similar Articles

Cited By

No available data.