Symptomatic myoma treated with laparoscopic uterine vessel occlusion and subsequent immediate myomectomy: which is the optimal surgical approach?

Laparoscopic transient uterine artery occlusion and myomectomy for symptomatic uterine myoma

“…Second, no differences in menorrhea were found between the prediseased state and the postoperative state in the LTUAL and LM groups, so we inferred that LTUAL had minimal interference on ovary function. In our previous study (8) and in the recent literature (12,16,17), the recurrence rate using LUAO was low and markedly lower than that reported for abdominal myomectomy and LM (18)(19)(20). The decreased blood supply to the uterus induced gradual necrosis of the myomas.…”

Use of uterine vessel occlusion in the management of uterine myomas: two different approaches

“…The blood loss during operation was minimal in both groups, without further comparison. To evaluate variations in postoperative pain, we used a self-reported 6-point verbal numeric rating scale (VNRS-6) (modified visual analogue scale) and a clinical practice of pain score (analgesic usage score [AUS]) based on analgesic use (a 200-mg etodolac capsule; Lonine, TTY Biopharm, Taoyuan, Taiwan), which have been described previously (40)(41)(42). The number of etodolac capsules the patients took was also recorded.…”

Basal FSH level changes after different types of uterine vessel occlusion in the management of uterine fibroids

“…A similar method performed by surgeons was uterine vessel occlusion. The efficacy of UAE has been shown with the successful reduction of fibroid and uterine size 3-12 months after the procedure and relief of excessive menstrual bleeding or pressure in 80%-90% of patients (5)(6)(7)(8)(9), with similar results for uterine vessel occlusion (10)(11)(12)(13)(14)(15)(16)(17).…”

“…In fact, the uterine vessel occlusion (which some papers call uterine artery occlusion) procedure can be further classified into 2 different strategies, based on the literature (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). One is uterine artery occlusion alone (UAO) without simultaneous blockage of the uterine vessels and the anastomotic sites between the uterine vessels and the ovarian vessels.…”

“…The other is uterine artery occlusion with simultaneous blockage of the uterine vessels and the anastomotic sites between the uterine vessels and the ovarian vessels (UVO). Some studies have reported the use of the UVO procedure in the management of uterine fibroids (8,12,16,21) and other studies the UAO procedure for the same purpose (10,(17)(18)(19)(20)(21). Both procedures have been used successfully in the management of symptomatic fibroids (21).…”