Laparoscopic occlusion of uterine vessels improves symptomatic fibroids

Laparoscopic occlusion of uterine vessels effectively relieves symptoms associated with uterine fibroids, according to a report in the January issue of the American Journal of Obstetrics and Gynecology.

“It is possible for gynecologists with an interest in endoscopy to treat fibroids conservatively with less postoperative pain and with identical results as radiological embolization,” Dr. Olav Istre from University of Oslo, Norway told Reuters Health.Dr. Istre and colleagues compared laparoscopic closure of the uterine arteries with radiologic embolization of the fibroids in 46 premenopausal women with symptomatic uterine fibroids.Laparoscopic closure of the uterine vessels was successful in all 22 patients, the authors report, and embolization was technically successful in all but 1 of 24 women.Postoperative pain and the use of pain medications were lower in the group treated with laparoscopic closure, the report indicates, though only the difference in pain medication consumption reached statistical significance.The reduction in dominant fibroid volume at 6 months was similar after both procedures, the researchers note, as was the degree of bleeding reduction after 6 months.Laparoscopic occlusion of uterine vessels “suitable for conservative treatment of uterine fibroids and especially in younger women with multiple fibroids where hysterectomy is out of the question,” Dr. Istre said.In these women, the largest fibroids can be removed laparoscopically, while the others can be removed with arterial occlusion, leaving the fibroids to shrink over time, he explained. “The heavy menstrual bleeding will be reduced, and the patient might be able to conceive.”(Source: Am J Obstet Gynecol 2004;190:37-43: Reuters Health: Will Boggs, MD: February 12, 2004: Oncolink)