Uterine artery ligation for the treatment of fibroids

Objective. To determine the efficacy of bilateral uterine artery ligation in the treatment of symptomatic uterine fibroids. Design. A descriptive study. Setting. Tertiary care gynecological clinic, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria. Sample. Fifty women who had trans-vaginal bilateral uterine artery ligation for the treatment of uterine fibroids between January 2003 and January 2006. Methods. Pre-operative baseline ultrasonic measurements of uterine and dominant fibroid volumes were carried out and repeated at two, six, and 12 weeks, then three monthly for a period of three years. Severity of menstrual blood loss, changes in pain symptoms and patients' satisfaction were also assessed. Main outcome measures. Changes in uterine and fibroid volumes, hemoglobin values, menstrual pain ratings, and patients' satisfaction ratings. Results. The mean fibroid volume, mean uterine volume, and mean menstrual pain rating showed statistically significant reductions at six, 12, and 36 months. The mean hemoglobin level and patients' satisfaction rating showed a statistically significant increase after six, 12, and 36 months. Conclusion. Trans-vaginal bilateral uterine artery ligation is a safe and effective method for the treatment of symptomatic uterine fibroids especially in areas where access to high level medical technology is restricted.