Vaginal expulsion of submucous myomas after laparoscopic-assisted uterine depletion of the myomas

被引:17
作者
Liu, WM [1 ]
Yen, YK [1 ]
Wu, YC [1 ]
Yuan, CC [1 ]
Ng, HT [1 ]
机构
[1] Natl Yang Ming Univ, Dept Obstet & Gynecol, Vet Gen Hosp, Taipei 112, Taiwan
来源
JOURNAL OF THE AMERICAN ASSOCIATION OF GYNECOLOGIC LAPAROSCOPISTS | 2001年 / 8卷 / 02期
关键词
D O I
10.1016/S1074-3804(05)60589-0
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Study Objective. To determine the safety and side effects that may be caused by laparoscopic-assisted uterine depletion (LAUD) of submucous myomas. Design. Retrospective chart review and follow-up (Canadian Task Force classification II-2). Setting. University-affiliated tertiary referral center. Patients. Five hundred twenty women with symptomatic myomas warranting surgical treatment, who wished to retain their uteri. Intervention. Laparoscopic bipolar coagulation of uterine arteries and anastomotic sites of uterine arteries with ovarian arteries. Measurements and Main Results. Postoperative sonographs showed submucous myomas in 53 (10.2%) women. During follow-up for a mean of 8.6 months very few complications occurred; however, nine women (1.7%) experienced vaginal expulsion of myomas from 2 weeks to 5 months postoperatively. Four of them were readmitted within 43 days with high fever and fetid discharge, and cervical cultures revealed heavy growth of Escherichia coli in three. Vaginal myomectomy was performed in six patients, and one woman passed the myoma spontaneously. Histopathologic studies of these nine specimens showed that two had infarction, three had coagulative necrosis, and four had degeneration. After treatment, all nine women had normal menstruation and their symptoms resolved during follow-up of at least 3 months. Conclusion. In our experience LAUD led to satisfactory symptomatic improvement and reduction in myoma volume and few complications. If vaginal expulsion of submucous fibroids can be viewed as a side effect, we should pay close attention to women with submucous myomas, especially within 2 months of LAUD. Otherwise, more dangerous complications could occur.
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页码:267 / 271
页数:5
相关论文
共 15 条
  • [1] Berkowitz RP, 1999, J REPROD MED, V44, P373
  • [2] PELVIC PAIN COMPLICATING LHRH ANALOG TREATMENT OF FIBROIDS
    CHIPATO, T
    HEALY, DL
    VOLLENHOVEN, B
    BUCKLER, HM
    [J]. AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY, 1991, 31 (04) : 383 - 384
  • [3] ELLENBOGEN A, 1989, LANCET, V2, P167
  • [4] Preliminary experience with uterine artery embolization for uterine fibroids
    Goodwin, SC
    Vedantham, S
    McLucas, B
    Forno, AE
    PErrella, R
    [J]. JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 1997, 8 (04) : 517 - 526
  • [5] Laparoscopic bipolar coagulation of uterine vessels to treat symptomatic leiomyomas
    Liu, WM
    [J]. JOURNAL OF THE AMERICAN ASSOCIATION OF GYNECOLOGIC LAPAROSCOPISTS, 2000, 7 (01): : 125 - 129
  • [6] Laparoscopic bipolar coagulation of uterine vessels: a new method for treating symptomatic fibroids
    Liu, WM
    Ng, HT
    Wu, YC
    Yen, YK
    Yuan, CC
    [J]. FERTILITY AND STERILITY, 2001, 75 (02) : 417 - 422
  • [7] MATTA WHM, 1988, FERTIL STERIL, V49, P1083
  • [8] MISHELL DR, 1997, COMPREHENSIVE GYNECO, P467
  • [9] LAPAROSCOPIC MYOLYSIS WITH THE ND-YAG LASER
    NISOLLE, M
    SMETS, M
    MALVAUX, V
    ANAF, V
    DONNEZ, J
    [J]. JOURNAL OF GYNECOLOGIC SURGERY, 1993, 9 (02) : 95 - 99
  • [10] PERL V, 1987, FERTIL STERIL, V48, P383