Treatment outcomes of uterine artery embolization and laparoscopic uterine artery ligation for uterine myoma.
In treating women with leiomyoma and who wish to preserve their uterus, laparoscopic uterine artery ligation or uterine artery embolization should be considered as possible options. This study was performed to evaluate the efficacy of laparoscopic uterine artery ligation and uterine artery embolization in treating uterine myoma. The treatment outcomes of 23 patients who underwent uterine artery embolization and 17 laparoscopic uterine artery ligation were evaluated. The uterine volume reduced 3 months after uterine artery embolization, but thereafter no significant changes were observed. On the other hand, the uterine volumes were only slightly reduced 3 months after laparoscopic uterine artery ligation, and slightly more reduced 6 months later. The average reduction in the case of laparoscopic uterine artery ligation was about 58.5%. After laparoscopic uterine artery ligation, 20% of the patients complained of vaginal spotting. Furthermore, the mechanism of volume reduction was evaluated using specimens obtained from a biopsy taken after each procedure. The results suggested that laparoscopic uterine artery ligation results mainly in physiologic cell death, that is apoptosis, whereas, the corresponding result is cell necrosis for uterine artery embolization. Uterine artery embolization and laparoscopic uterine artery ligation are both effective in relieving the symptoms caused by uterine myoma, and therefore both procedures can be used in place of hysterectomy or myomectomy.
Park
Ki-Hyun
KH
Department of Obstetrics and Gynecology, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea. ob@yumc.yonsei.ac.kr
Kim
Jeong-Yeon
JY
Shin
Jong-Seung
JS
Kwon
Ja-Young
JY
Koo
Ja-Seong
JS
Jeong
Kyung-Ah
KA
Cho
Nam-Hoon
NH
Bai
Sang-Wook
SW
Lee
Byung-Seok
BS
D000328:Adult; D001158:Arteries; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007889:Leiomyoma / Q000628:therapy*; D008026:Ligation; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000628:therapy*; D014599:Uterus / Q000098:blood supply*