Laparoscopic occlusion of uterine vessels for the treatment of symptomatic fibroids: Initial experience and comparison to uterine artery embolization.
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.


METHODS
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.


CONCLUSIONS
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.
Hald
Kirsten
K
Departments of Obstetrics and Gynecology, Ullevaal Hospital, University of Oslo, Oslo, Norway.
Langebrekke
Anton
A
Kløw
Nils Einar
NE
Noreng
Hans Jørgen
HJ
Berge
Anette Bugge
AB
Istre
Olav
O
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage; D001808:Blood Vessels / Q000473:pathology; D004305:Dose-Response Relationship, Drug; D004621:Embolization, Therapeutic / Q000009:adverse effects; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D007889:Leiomyoma / Q000150:complications / Q000601:surgery* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008614:Meperidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy / Q000503:physiopathology; D014594:Uterine Neoplasms / Q000150:complications / Q000601:surgery* / Q000628:therapy; D014599:Uterus / Q000098:blood supply* / Q000473:pathology; D014656:Vascular Surgical Procedures / Q000009:adverse effects
D000701:Analgesics, Opioid; D008614:Meperidine; C012394:ketobemidone