THREE DIMENSIONAL ULTRASOUND WITH POWER DOPPLER STUDY OF CHANGES IN UTERINE FIBROIDS AFTER LAPAROSCOPIC UTERINE ARTERIES OCCLUSION

Document Type : Original Article

Authors

1 Department Obstetrics & Gynecology Mansoura University Hospitals, Faculty of Medicine, Mansoura University

2 Department of Diagnostic Radiology Mansoura University Hospitals, Faculty of Medicine, Mansoura University

Abstract

Background: Uterine arteries occlusion either laparoscopically or radiologically has become an alternative to
hysterectomy treatment of symptomatizing uterine myomas. Despite these methods proved to be effective modalities of
treatment, yet its mechanism of improving the symptoms have not been clearly identified.
Objective: To assess the change of uterine and myoma volumes together with vascular change using 3Ds ultrasound
with power Doppler after laparoscopic uterine arteries occlusion.
Study design : Prospective clinical study
Main outcome measures: The percentage reduction in the total uterine and myoma size, changes in the vasculature of
the uterus and myomata and its correlation to the clinical response was evaluated.
Results: From 40 patients recruited in the study 36 (90%) underwent technically successful! laparoscopic coagulation of
the uterine vessels without intra operative complications. The main follow up time was 3,6,12 months. Symptomatic
improvement occured in 88.9% and mass reduction in uterine and myoma volumes respectively was 64.6% and 78.8%.
Also, there was a significant difference between pre and post operative power doppler study uterine vascular
assessment among improved patients.
Conclusion: Symptoms improvement occurs in laparoscopic uterine arteries occlusion is mainly correlated to changes
in vascular supply to the uterus and myoma that lead to cell death or apoptosis which consequently reduces the myoma
size and clinically improve the patient symptoms.

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