title: Laparoscopic occlusion of uterine vessels for the treatment of symptomatic fibroids: Initial experience and comparison to uterine artery embolization.
abstract: 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.
authors.affiliation: Departments of Obstetrics and Gynecology, Ullevaal Hospital, University of Oslo, Oslo, Norway.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Hald
authors.forename: Anton
authors.initials: A
authors.lastname: Langebrekke
authors.forename: Nils Einar
authors.initials: NE
authors.lastname: Kløw
authors.forename: Hans Jørgen
authors.initials: HJ
authors.lastname: Noreng
authors.forename: Anette Bugge
authors.initials: AB
authors.lastname: Berge
authors.forename: Olav
authors.initials: O
authors.lastname: Istre
mesh_terms: 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
chemical_list: D000701:Analgesics, Opioid; D008614:Meperidine; C012394:ketobemidone