Midterm follow-up study of laparoscopic dissection of uterine vessels for surgical treatment of symptomatic fibroids.
BACKGROUND
This study aimed to assess laparoscopic dissection of uterine vessels (LDUV) for symptomatic fibroids in women.


METHODS
A total of 69 women entered the study between March 2000 and June 2003. In this case series, 68 consecutive women underwent LDUV using ultrasonically activated sheers or electrosurgery for the treatment of fibroids over 3 years (median follow-up period, 14.5 months). Ultrasound or magnetic resonance imaging was carried out 3, 6, 12, 24, and 36 months after treatment. The tissue markers, gonadotropin, and estrogen levels were studied postoperatively.


RESULTS
Almost all the patients (98.5%) had a successful LDUV with a low rate (7.3%) of postoperative complications. The time of surgery ranged from 15 to 50 min (mean, 30.8 min). The blood loss was minimal (mean, 14.7 ml), and the hospital stay was 2.4 days. Symptom improvement (menorrhagia or dysmenorrhoea) was 93.2%, and the average reduction in the dominant myoma was 57.8% during a follow-up period longer than 12 months. All the patients with anemia had normal red cell counts after 3 months.


CONCLUSIONS
Uterine volume and the dominant fibroid were significantly reduced and symptoms were improved by LDUV. The laparoscopic procedure is associated with insignificant tissue damage and normal gonadotropin and estrogen levels.
Holub
Z
Z
Department of Obstetrics and Gynecology, Endoscopic Training Center, Baby Friendly Hospital, Vancurova Street 1548, 272 58, Kladno. holubz@seznam.cz
Jabor
A
A
Lukac
J
J
Kliment
L
L
Urbanek
S
S
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D007889:Leiomyoma / Q000098:blood supply* / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D014594:Uterine Neoplasms / Q000098:blood supply* / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods