Our Summary

This research paper studied the effects of a surgical procedure called uterine artery occlusion (UAO) when used in combination with myomectomy, a surgery to remove fibroids from the uterus. Researchers reviewed 26 studies that involved nearly 3,000 patients. They compared the experiences of patients who had UAO along with myomectomy (UAO+M) to those who just had myomectomy.

The results showed that patients who had UAO+M had less blood loss during surgery and were less likely to need a blood transfusion. They also had a lower risk of fibroid recurrence. However, the surgery took slightly longer than just myomectomy. On the upside, patients having UAO+M tended to spend less time in the hospital after surgery.

Even though the results are promising, the researchers say more studies are needed to understand the impact of UAO+M on women who want to have children in the future. They want to make sure this procedure doesn’t affect the ovaries or the ability to get pregnant.

FAQs

  1. What is the benefit of combining uterine artery occlusion (UAO) with myomectomy?
  2. How does the UAO+M procedure impact the length of hospital stay compared to a standard myomectomy?
  3. Is there potential for UAO+M to affect fertility or ovarian function?

Doctor’s Tip

One helpful tip a doctor might tell a patient about myomectomy is to discuss the option of uterine artery occlusion (UAO) with them. UAO can potentially reduce blood loss during surgery, lower the risk of needing a blood transfusion, and decrease the chances of fibroid recurrence. However, it is important to consider the potential impact on fertility and ovaries, especially for women who want to have children in the future. It is recommended to have a thorough discussion with your healthcare provider about the benefits and risks of UAO in combination with myomectomy before making a decision.

Suitable For

Patients who are typically recommended for myomectomy include those who have symptomatic fibroids that are causing heavy menstrual bleeding, pelvic pain, pressure or discomfort, and fertility issues. Myomectomy is often recommended for women who wish to preserve their uterus and fertility, as it allows for the removal of fibroids while leaving the uterus intact. Additionally, myomectomy may be recommended for women who have fibroids that are causing recurrent miscarriages or other pregnancy complications.

Timeline

Before myomectomy:

  1. Patient may experience symptoms such as heavy menstrual bleeding, pelvic pain, and pressure.
  2. Patient consults with a gynecologist who recommends a myomectomy to remove fibroids.
  3. Patient undergoes preoperative testing and preparation for surgery.

During myomectomy:

  1. Surgical team performs myomectomy to remove fibroids from the uterus.
  2. In some cases, uterine artery occlusion (UAO) may be used in combination with myomectomy to reduce blood loss.

After myomectomy:

  1. Patient may experience some pain and discomfort post-surgery.
  2. Recovery period involves rest, pain management, and follow-up appointments with the gynecologist.
  3. Patients who had UAO+M may experience less blood loss, lower risk of fibroid recurrence, and shorter hospital stay compared to those who had just myomectomy.
  4. Long-term follow-up is needed to monitor the impact of UAO+M on future fertility and ovarian function.

What to Ask Your Doctor

  1. What is the success rate of myomectomy with uterine artery occlusion (UAO) compared to traditional myomectomy alone?
  2. What are the potential risks and complications associated with UAO during myomectomy?
  3. How does UAO affect fertility and the ability to conceive in the future?
  4. Will UAO+M impact my menstrual cycle or hormonal balance?
  5. What is the recovery process like for patients who undergo UAO+M compared to traditional myomectomy?
  6. Are there any long-term effects or considerations to keep in mind after having UAO during myomectomy?
  7. How do I know if I am a good candidate for UAO+M versus traditional myomectomy?
  8. What are the alternative treatment options for fibroids if I am not a candidate for UAO+M?
  9. Will UAO+M affect my chances of having a successful pregnancy in the future?
  10. Are there any specific lifestyle changes or precautions I should take after undergoing UAO+M for myomectomy?

Reference

Authors: Sanders AP, Chan WV, Tang J, Murji A. Journal: Fertil Steril. 2019 Apr;111(4):816-827.e4. doi: 10.1016/j.fertnstert.2018.12.011. Epub 2019 Jan 17. PMID: 30661604