Laparoscopic occlusion of uterine vessels for the treatment of symptomatic fibroids: Initial experience and comparison to uterine artery embolization

Am J Obstet Gynecol. 2004 Jan;190(1):37-43. doi: 10.1016/s0002-9378(03)00910-4.

Abstract

Objective: Our purpose was to evaluate the effects of laparoscopic occlusion of uterine vessels in treating symptomatic fibroids and compare with embolization of the uterine arteries.

Study design: We studied 46 premenopausal women, aged 43 (34-51) years with symptomatic uterine fibroids, undergoing radiologic embolization (n=24) and laparoscopy closure of the uterine arteries (n=22).

Results: The laparoscopic technique reduced picture blood assessment score after 6 months by 50% from an initial value of 345 (+/-288). Uterus volume was reduced by 37% (+/-18%), and the dominant fibroid was reduced by 36% (+/-31%). Postoperative pain and use of pain relief differed significantly, requiring more pain medication after embolization: ketobemidon 38 mg compared with 16 mg in the laparoscopic group (P=.008). Specific complications to the laparoscopic technique were temporary damage to the obturator nerve in three patients.

Conclusion: Laparoscopic occlusion of uterine vessels is a promising new method for treating fibroid-related symptoms, with less postoperative pain than embolization and comparable effects on symptoms.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Analgesics, Opioid / administration & dosage
  • Blood Vessels / pathology
  • Dose-Response Relationship, Drug
  • Embolization, Therapeutic / adverse effects
  • Female
  • Humans
  • Laparoscopy* / adverse effects
  • Leiomyoma / complications
  • Leiomyoma / surgery*
  • Leiomyoma / therapy
  • Magnetic Resonance Imaging
  • Meperidine / administration & dosage
  • Meperidine / analogs & derivatives*
  • Middle Aged
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / physiopathology
  • Uterine Neoplasms / complications
  • Uterine Neoplasms / surgery*
  • Uterine Neoplasms / therapy
  • Uterus / blood supply*
  • Uterus / pathology
  • Vascular Surgical Procedures* / adverse effects

Substances

  • Analgesics, Opioid
  • Meperidine
  • ketobemidone