Laparoscopic occlusion of uterine vessels for the treatment of symptomatic fibroids: Initial experience and comparison to uterine artery embolization |
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Authors: | Hald Kirsten Langebrekke Anton Kløw Nils Einar Noreng Hans Jørgen Berge Anette Bugge Istre Olav |
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Affiliation: | Departments of Obstetrics and Gynecology, Ullevaal Hospital, University of Oslo, Oslo, Norway. |
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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. |
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Keywords: | Leiomyoma radiology embolization laparoscopy |
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