Laparoscopic uterine artery ligation for treatment of symptomatic adenomyosis.
OBJECTIVE
To investigate the effect of laparoscopic uterine artery ligation on symptomatic adenomyosis.


METHODS
Prospective pilot study (Canadian Task Force classification II-2).


METHODS
Tertiary care major teaching hospital.


METHODS
Twenty women with symptomatic adenomyosis.


METHODS
Laparoscopic ligation of bilateral uterine arteries with hemoclips and electrocoagulation of bilateral uterine ovarian vessels.


RESULTS
Patients underwent sonographic measurement of uterine size, and recorded amount of menstruation and dysmenorrhea preoperatively and postoperatively. Six months postoperatively, mean uterine size had decreased by an amount ranging from 0.4% to 74.0%. Two of nine women achieved remission of the mass effect of an enlarged uterus. Thirteen of 16 patients achieved bleeding control and 5 returned to eumenorrhea or hypomenorrhea. Twelve of 16 patients achieved control of dysmenorrhea and 6 were analgesic free. However, nine women experienced nonmenstrual pain after surgery, three of whom underwent hysterectomy later. Treatment was rated as satisfactory by 15% of patients, but 45% were dissatisfied. Seventeen women would have refused to undergo the procedure if they could make the decision again.


CONCLUSIONS
Poor satisfaction in this preliminary study suggests that symptomatic adenomyosis may not be effectively treated by laparoscopic uterine artery ligation.
Wang
Chin-Jung
CJ
Division of Gynecologic Endoscopy, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Hsin Street, Kwei-Shan Tao-Yuan, Taiwan.
Yen
Chih-Feng
CF
Lee
Chyi-Long
CL
Soong
Yung-Kuei
YK
D000328:Adult; D001158:Arteries / Q000601:surgery; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000601:surgery*; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery*; D014599:Uterus / Q000098:blood supply*