الفهرس 
Uterine FibroidsOnly 14 pages are availabe for public view
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Abstract
Introduction: Fibroids are the most common benign tumor in women, affecting about 20 – 40% of women in reproductive age. Among the available modalities for treating leiomyoma, hysterectomy is the most frequently performed method. Aim of work: To evaluate the safety and efficiency of laparoscopic bipolar coagulation of uterine vessels in treating symptomatic fibroids. Patients and methods: In current study; one hundred patients presented by abnormal bleeding per vagina due to presence of uterine fibroid submitted to one of 3 procedures; 40 patients submitted to LOUA, 20 patients to embolization of uterine arteries and last 40 patients submitted to myomectomy. All of these patients addressed failed hormonal therapy, counseled extensively regarding; potential risks, benefits, curative nature, fertility issues regarding each procedure and informed written consent was obtained from all patients. Post procedure follow up at 3, 6, 12 months for improvement of bleeding, reduction in uterine and myoma volumes (ultrasound assessment), decrease in uterine blood flow (Doppler ultrasound on both uterine arteries). Results: From 40 patients submitted to LOUA, 36 patients (90%) underwent technically successful LOUA, 32 of them (88.9%) showed improvement of bleeding. Similar results had been observed in perimenopausal & premenopausal cases (100% versus 86.7%) (P = 0.248) and also metrorrhagia and menorrhagia patients (90% versus 88.48%) (P = 0.094). Reduction of uterine and myoma volumes for patients underwent LOUA had been observed through ultrasound follow up with higher reduction in myoma size than uterine size (78.8% versus 64.6%). Reduction of uterine and myoma volumes by US in LOUA patients had been similar in; peri and premenopausal women (average reduction 63.9% & 75.04% versus 65.4% & 80.04%) (P = 0.199 & 0.320 respectively), patients with myoma size 5 cm and those with myoma size > 5 cm (average reduction 64.9% & 78.5% versus 65.02% & 79.7%) (P = 0.779 & 0.703 respectively) and in intramural and submucous myoma cases (average reduction 64.4% & 79.8% versus 65.80% & 76.09%) (P = 0.251 & 0.241 respectively) and better results had been noted in multiple than solitary myoma cases (average reduction 71.7% & 84.8% versus 63.8% & 78.3%) (P = 0.420 & 0.030 respectively). Conclusions: It had been concluded that uterine artery occlusive methods (namely UAE and LOUA) are a promising new methods for treatment of uterine myomas with a comparable effects to that of myomectomy and fewer side effects than myomectomy. LOUA is as effective as embolization as a treatment for fibroid related bleeding with fewer complications than embolization.