At the end of the embolisation, another arteriogram was performed to ensure that the blood supply to the dominant myoma
was obstructed (Fig.
Preoperative information included the family history, fibroid age, irregular bleeding history, the diameter, location, blood flow of pseudo-capsule of the largest myoma
according to ultrasound, and whether there was excessive growth compared with the previous ultrasound examination.
Laparoscopic Findings Findings Primary Secondary Total Infertility Infertility Myoma
3 (4%) 2 (7%) 5 Adenomyosis 1 (1%) 2 (7%) 3 Endometriosis 8 (11%) 3 (10%) 11 Uterine anomalies 5 (7%) 2 (7%) 7 Adnexal adhesions 4 (5%) 8 (28%) 12 Ovarian cyst 3 (4%) 4 (14%) 7 Polycystic Ovarian Disease 36 (50%) 12 (42%) 48 Unilateral tubal block 8 (11%) 6 (21%) 14 Bilateral tubal block 5 (7%) 13 (46%) 18 Table 4.
However, hyperplasia, carcinoma, endometrial atrophy, and myomas
are also possibilities.
H/S is the gold standard for detecting the endometrial polyps, submucous myomas
and intrauterine synechia in the uterine cavity.
The echographic examination showed a gestational sac fully displaced by two intramural uterine myomas
, 20 cm each, located in the uterine fundus and in the left anterior wall close to the uterine blood vessels of the same side and in the vicinity of the cervix.
Reproductive outcome before and after laparoscopic or abdominal myomectomy for subserous or intramural myomas
Disseminated leiomyomas occurring after laparoscopic morcellation of a myoma
is a rare but reported entity.
Three categories of interventions can be identified (a) interventions on uterine arteries such as laparoscopic uterine artery ligation, uterine artery embolization, pericervical mechanical tourniquet for uterine arteries and hormonal tourniquets such as vasopressin; (b) uterotonics such as ergometrine, oxytocin, misoprostol and sulprostone and (c) myoma
dissection techniques which include the use of laser, electrosurgery and chemical dissectors such as sodium-2-mercaptoethanesulfonate (Mesna) (5-10).
Epstein JH, Nejat EJ, Tsai T Parasitic myomas
after laparoscopic myomectomy: case report.
The criterion for inclusion in the study was the presence of myomas
confirmed by visual inspection of the uterus during CS and the application of intraoperative cell salvage device, i.
6cm) with posterior uterine body, anterior uterine body, and subserosal myomas