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.


METHODS
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.


CONCLUSIONS
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.
Harmanli
Ozgur H
OH
Department Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, Temple University, 3401 North Broad Street, 7OPD, Philadelphia, PA 19140, USA. ozgur.harmanli@temple.edu
Khandelwal
Meena
M
D001158:Arteries; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D008026:Ligation / Q000379:methods; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D014599:Uterus / Q000098:blood supply*; D014621:Vagina / Q000601:surgery