The role of laparoscopic dissection of the uterine artery in the surgical treatment of fibroid-related menorrhagia: a pilot study

This pilot study assessed the outcome, tissue trauma, clinical improvement and reduction in size of fibroids following laparoscopic dissection of the uterine artery (LDUA) in fibroid-related menorrhagia. Fifty-three patients with complete records were included in the prospective clinical study. Before LDUA, and 3 and 6 months following the procedure, ultrasonography or MRI was done to measure the size of the uterus and dominant fibroid. Blood samples for hemoglobin and assay of marker inflammatory response and tissue trauma were taken preoperatively on the 1st and 3rd postoperative days. All patients underwent successful LDUA using ultrasonically activated shears without intra-operative complications. Fifty (96.2%) laparoscopically treated patients with fibroids who subsequently experienced improvement in menorrhagia and anemia are described. The LDUA procedure can be completed within 30–40 min with only minimal blood loss and a short hospital stay if performed by experienced surgeons. Our study results show that single laparoscopic dissection of the uterine artery performed with ultrasonic technique is associated with an insignificant stress response. The average reductions in the uterine volume and dominant fibroid volume were 36.6 and 57.9% at 6 months after surgery, respectively. Four women conceived within 1 year, and their pregnancies were without complications during gestation.