Our Summary

This research paper is about three different surgical methods for blocking the blood flow to the uterus. This is done to reduce bleeding during a type of surgery called a myomectomy, which is used to remove fibroids (non-cancerous growths in the uterus). The study outlines the steps involved in the procedure and shows video footage of the surgery.

The methods for blocking the blood flow (known as uterine artery occlusion) depend on the patient’s body structure. The first step is to decide the best approach to block the artery - from the side (lateral), from the back (posterior), or from the front (anterior). Next, the surgeon identifies the important anatomical landmarks for the procedure. Then, the uterine artery and the ureter (a tube that carries urine from the kidneys to the bladder) are identified. Finally, the uterine artery is blocked.

The study found that in all cases, the surgeons were able to clearly identify the uterine artery and the ureter, and were successful in blocking the uterine artery. The research suggests that this technique is effective in limiting blood loss, the need for blood transfusion, and the chance of fibroids coming back, although it may slightly increase the duration of the surgery.

FAQs

  1. What is the purpose of a uterine artery occlusion during a myomectomy procedure?
  2. What are the three different approaches to uterine artery occlusion, and how are they selected?
  3. What are the main outcomes measured after a successful uterine artery occlusion in myomectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about myomectomy is to discuss the option of uterine artery occlusion as a blood-sparing intraoperative technique. This technique can help reduce blood loss during the procedure, potentially decreasing the need for blood transfusions and promoting faster recovery. The doctor can explain the different approaches to uterine artery occlusion and how it can benefit the patient during their myomectomy surgery.

Suitable For

Patients who are typically recommended myomectomy are those with symptomatic uterine fibroids, including those experiencing heavy menstrual bleeding, pelvic pain or pressure, urinary frequency, or infertility. Myomectomy may be recommended for patients who wish to preserve their fertility or for those who prefer a less invasive approach compared to hysterectomy. Additionally, patients with large or multiple fibroids that are causing significant symptoms may also be candidates for myomectomy.

Timeline

Before myomectomy:

  • Patient undergoes pre-operative evaluation and consultation with their healthcare provider
  • Imaging studies may be performed to confirm the presence and location of uterine fibroids
  • Anesthesia is administered before the surgical procedure
  • Uterine artery occlusion is performed to reduce blood loss during the myomectomy

After myomectomy:

  • Patient is monitored closely in the post-operative recovery area
  • Pain management medications are provided to help with discomfort
  • Patient may experience cramping and vaginal bleeding in the days following the procedure
  • Follow-up appointments with the healthcare provider are scheduled to monitor recovery and address any concerns
  • Patient may resume normal activities after a period of rest and recovery

What to Ask Your Doctor

  1. What are the different approaches to uterine artery occlusion during myomectomy and how do you determine which approach is best for my individual anatomy?
  2. What are the potential risks and benefits of uterine artery occlusion during myomectomy?
  3. How does uterine artery occlusion help to limit blood loss during the procedure?
  4. What is the success rate of uterine artery occlusion in terms of reducing the need for blood transfusion and preventing fibroid recurrence?
  5. Are there any specific precautions or guidelines I should follow before or after undergoing myomectomy with uterine artery occlusion?
  6. How long does the procedure typically take when uterine artery occlusion is performed?
  7. What is the recovery process like after myomectomy with uterine artery occlusion?
  8. Are there any potential long-term effects or complications associated with uterine artery occlusion during myomectomy?
  9. What is the likelihood of needing additional treatments or procedures in the future after undergoing myomectomy with uterine artery occlusion?
  10. Are there any alternative treatment options to consider aside from myomectomy with uterine artery occlusion?

Reference

Authors: Zakhari A, Sanders AP, Murji A. Journal: Fertil Steril. 2019 May;111(5):1030-1031. doi: 10.1016/j.fertnstert.2019.01.019. Epub 2019 Mar 11. PMID: 30871760