title: Directed laparoscopic cryomyolysis: a possible alternative to myomectomy and/or hysterectomy for symptomatic leiomyomas.
abstract: OBJECTIVE
  The purpose of this study was to develop a minimally invasive, safe, and effective technique for managing symptomatic uterine myomas.
  
  
  METHODS
  Twenty patients with symptomatic uterine fibroids were treated. All had complaints of abnormal bleeding and/or pelvic pain/pressure and/or urinary frequency. Myoma diameters were 4 to 8 cm. Power color Doppler imaging was performed preoperatively and postoperatively to determine the effectiveness of cryomyolysis in reducing or eliminating the primary blood supply, as well as regression of the myomas. Laparoscopic cryomyolysis was performed with use of the Her Option Cryoablation System (American Medical Systems Gynecology, San Diego, Calif). Patients were evaluated at 1, 3, and 6 months postoperatively.
  
  
  RESULTS
  All patients were discharged within 24 hours of treatment. No intraoperative or postoperative complications occurred. Of the 20 patients treated, 19 had complete resolution of their complaints. Myomas regressed up to 80%, and major blood supply to the myomas was eliminated.
  
  
  CONCLUSIONS
  Directed laparoscopic cryomyolysis is an effective and safe technique for symptom relief from leiomyomas.
authors.affiliation: Department of Gynecology, Tor Vergata University of Rome, Rome, Italy. ezupi@libero.it
authors.forename: Errico
authors.initials: E
authors.lastname: Zupi
authors.forename: Alessio
authors.initials: A
authors.lastname: Piredda
authors.forename: Daniela
authors.initials: D
authors.lastname: Marconi
authors.forename: Duane
authors.initials: D
authors.lastname: Townsend
authors.forename: Caterina
authors.initials: C
authors.lastname: Exacoustos
authors.forename: Domenico
authors.initials: D
authors.lastname: Arduini
authors.forename: Beata
authors.initials: B
authors.lastname: Szabolcs
mesh_terms: D000328:Adult; D001808:Blood Vessels / Q000000981:diagnostic imaging; D003452:Cryosurgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007889:Leiomyoma / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery*; D007902:Length of Stay; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009215:Myometrium; D016896:Treatment Outcome; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery*