Temporary endovascular balloon occlusion of the bilateral internal iliac arteries for control of hemorrhage during laparoscopic-assisted myomectomy in a nulligravida with a large cervical myoma.
OBJECTIVE
To describe the preoperative evaluation and minimally invasive management of a large cervical myoma in a nulligravida who wished to preserve fertility.


METHODS
Case report.


METHODS
Departments of obstetrics and gynecology and radiology at a general hospital.


METHODS
A 33-year-old nulligravida with a large cervical myoma.


METHODS
A large cervical myoma was preoperatively diagnosed by ultrasonography, magnetic resonance imaging, and computed tomographic angiography and was successfully treated with minimal blood loss by laparoscopic-assisted myomectomy combined with prophylactic temporary endovascular balloon occlusion of the bilateral internal iliac arteries.


METHODS
Uterine conservation.


RESULTS
Fertility preservation was achieved with minimal blood loss in a nulligravida with a large cervical myoma.


CONCLUSIONS
Laparoscopic-assisted myomectomy combined with prophylactic endovascular balloon occlusion of the bilateral internal iliac artery was an effective minimally invasive procedure to preserve fertility in a nulligravida with a large cervical myoma.
Takeda
Akihiro
A
Department of Obstetrics and Gynecology, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan. gyendoscopy@gmail.com
Koyama
Kazuyuki
K
Imoto
Sanae
S
Mori
Masahiko
M
Sakai
Kotaro
K
Nakamura
Hiromi
H
D015901:Angiography, Digital Subtraction; D021721:Balloon Occlusion; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D005260:Female; D005298:Fertility; D020073:Gravidity; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D007083:Iliac Artery; D010535:Laparoscopy / Q000009:adverse effects*; D007889:Leiomyoma / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*