Laparoscopic bipolar coagulation of uterine vessels: a new method for treating symptomatic fibroids

Abstract

Objective: To evaluate the effects of laparoscopic bipolar coagulation of uterine vessels in treating symptomatic fibroids.

Design: Prospective clinical study.

Setting: University-affiliated tertiary referral center.

Patient(s): Eighty-seven women with symptomatic fibroids warranting surgical treatment and wanting to retain their uteri.

Intervention(s): Laparoscopic bipolar coagulation of uterine arteries and anastomotic sites of uterine arteries with ovarian arteries.

Main outcome measure(s): Percentage reduction in the dominant fibroid size and clinical response evaluation.

Result(s): Eighty-five (97.7%) of 87 patients underwent technically successful laparoscopic coagulation of uterine vessels without intraoperative complications. The mean follow-up time was 10.2 months. Symptomatic improvement was reported in 76 (89.4%) of 85 patients, including 18 (21.2%) with complete resolution of symptoms. Significant reductions in the dominant fibroid size (average, 76%) and the uterine volume (average, 46%) were sonographically demonstrated. Two patients conceived 4 and 9 months, respectively, after treatment. Three (3.5%) premenopausal women became postmenopausal postoperatively.

Conclusion(s): Laparoscopic bipolar coagulation of uterine vessels appears to be a promising new method for treating fibroid-related menorrhagia and pelvic pain.