Transvaginal uterine artery ligation in a woman with uterine leiomyomas. A case report

BACKGROUND: Uterine artery embolization by interventional radiologic techniques is an effective and widely used modality in the management of uterine leiomyomas. Anatomically, uterine arteries can be approached transvaginally with an appropriate surgical technique. In this report, we describe a novel, minimally invasive vaginal technique that also occluded the uterine arteries successfully. CASE: A 45-year-old woman with symptomatic leiomyomas decided to undergo a vaginal hysterectomy. During the procedure, Doppler ultrasonography demonstrated the cessation of blood flow after dissection and ligation of uterine arteries bilaterally without cutting the uterosacral and cardinal ligaments. CONCLUSION: Transvaginal ligation of the uterine arteries is possible. If validated by further clinical investigation, this minimally invasive gynecologic technique could be useful in selected cases of uterine leiomyomas.