title: Uterine artery embolization immediately preceding laparoscopic myomectomy.
abstract: OBJECTIVE
  To determine whether performing uterine artery embolization (UAE) immediately before laparoscopic myomectomy can facilitate a minimally invasive surgical approach for larger uterine fibroids.
  
  
  METHODS
  In a retrospective case-control study, laparoscopic myomectomy with and without preoperative UAE was examined. Data were analyzed from 26 laparoscopic myomectomies performed by a single surgeon at Northwestern University Feinberg School of Medicine between 2004 and 2010. Controls were matched for age, calendar year, surgeon, and number of fibroids removed. Surgical outcomes included preoperative clinical uterine size, operative time, operative blood loss, and postoperative myoma specimen weight. Data were analyzed via 2-tailed Student t test.
  
  
  RESULTS
  Twelve women underwent laparoscopic myomectomy within 169 ± 16minutes (mean ± SEM) of preoperative UAE. Fourteen control patients underwent laparoscopic myomectomy alone. The UAE group had a greater mean preoperative clinical uterine size (19.7 versus 12.4 weeks, P<0.001) and a greater mean myoma specimen weight measured postoperatively (595.3 versus 153.6 grams, P<0.05). There were no significant differences in operative time or blood loss, and there were no intra-operative complications.
  
  
  CONCLUSIONS
  UAE performed immediately before laparoscopic myomectomy facilitated minimally invasive surgery for larger uteri and larger uterine myomas, with no differences in operative time or blood loss.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
authors.forename: Kara N
authors.initials: KN
authors.lastname: Goldman
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Hirshfeld-Cytron
authors.forename: Mary-Ellen
authors.initials: ME
authors.lastname: Pavone
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Thomas
authors.forename: Robert L
authors.initials: RL
authors.lastname: Vogelzang
authors.forename: Magdy P
authors.initials: MP
authors.lastname: Milad
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D055357:Uterine Artery Embolization / Q000379:methods*
references.citation: Am J Obstet Gynecol. 2006 Nov;195(5):1266-71
references.pmid: 16796984
references.citation: Semin Reprod Med. 2010 May;28(3):228-34
references.pmid: 20414845
references.citation: Obstet Gynecol. 2002 Feb;99(2):229-34
references.pmid: 11814502
references.citation: Radiology. 2009 Feb;250(2):482-7
references.pmid: 19188316
references.citation: Fertil Steril. 2009 Aug;92(2):742-7
references.pmid: 18692826
references.citation: Am J Obstet Gynecol. 2003 Jan;188(1):100-7
references.pmid: 12548202
references.citation: Acta Obstet Gynecol Scand. 2010 Oct;89(10):1310-5
references.pmid: 20726700
references.citation: Eur J Obstet Gynecol Reprod Biol. 2009 Jul;145(1):14-21
references.pmid: 19398260
references.citation: Cardiovasc Intervent Radiol. 2008 May-Jun;31(3):514-20
references.pmid: 17624572
references.citation: Fertil Steril. 2007 Aug;88(2):255-71
references.pmid: 17658523
references.citation: J Vasc Interv Radiol. 2010 Jun;21(6):829-35; quiz 835
references.pmid: 20399113
references.citation: Obstet Gynecol. 2006 Oct;108(4):930-7
references.pmid: 17012456
references.citation: Hum Reprod. 2001 Apr;16(4):770-4
references.pmid: 11278231
references.citation: Fertil Steril. 2010 Jun;94(1):324-30
references.pmid: 19361799
references.citation: Am J Obstet Gynecol. 2009 Aug;201(2):127-35
references.pmid: 19646564
references.citation: J Minim Invasive Gynecol. 2008 May-Jun;15(3):346-9
references.pmid: 18439509
references.citation: Eur J Radiol. 2011 Jul;79(1):1-6
references.pmid: 19875261
references.citation: J Vasc Interv Radiol. 2009 Sep;20(9):1172-5
references.pmid: 19640736
references.citation: Obstet Gynecol. 2010 Sep;116(3):641-652
references.pmid: 20733447
references.citation: Radiat Prot Dosimetry. 2005;117(1-3):50-3
references.pmid: 16461528
references.citation: J Vasc Interv Radiol. 2010 Sep;21(9):1347-53
references.pmid: 20685136