Vaginal expulsion of submucous myomas after laparoscopic-assisted uterine depletion of the myomas

Wei Min Liu, Yuan Kuei Yen, Yi Cheng Wu, Chiou Chung Yuan, Heung Tat Ng

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Study Objective. To determine the safety and side effects that may be caused by laparoscopic-assisted uterine depletion (LAUD) of submucous myomas. Design. Retrospective chart review and follow-up (Canadian Task Force classification 11-2). Setting. University-affiliated tertiary referral center. Patients. Five hundred twenty women with symptomatic myomas warranting surgical treatment, who wished to retain their uteri. Intervention. Laparoscopic bipolar coagulation of uterine arteries and anastomotic sites of uterine arteries with ovarian arteries. Measurements and Main Results. Postoperative sonographs showed submucous myomas in 53 (10.2%) women. During follow-up for a mean of 8.6 months very few complications occurred; however, nine women (1.7%) experienced vaginal expulsion of myomas from 2 weeks to 5 months postoperatively. Four of them were readmitted within 43 days with high fever and fetid discharge, and cervical cultures revealed heavy growth of Escherichia coli in three. Vaginal myomectomy was performed in six patients, and one woman passed the myoma spontaneously. Histopathologic studies of these nine specimens showed that two had infarction, three had coagulative necrosis, and four had degeneration. After treatment, all nine women had normal menstruation and their symptoms resolved during follow-up of at least 3 months. Conclusion. In our experience LAUD led to satisfactory symptomatic improvement and reduction in myoma volume and few complications. If vaginal expulsion of submucous fibroids can be viewed as a side effect, we should pay close attention to women with submucous myomas, especially within 2 months of LAUD. Otherwise, more dangerous complications could occur.

Original languageEnglish
Pages (from-to)267-271
Number of pages5
JournalJournal of the American Association of Gynecologic Laparoscopists
Volume8
Issue number2
DOIs
Publication statusPublished - 2001
Externally publishedYes

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Myoma
Uterine Artery
Uterine Myomectomy
Menstruation
Leiomyoma
Advisory Committees
Tertiary Care Centers
Infarction
Uterus
Fever
Necrosis
Arteries
Escherichia coli
Safety
Therapeutics
Growth

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Vaginal expulsion of submucous myomas after laparoscopic-assisted uterine depletion of the myomas. / Liu, Wei Min; Yen, Yuan Kuei; Wu, Yi Cheng; Yuan, Chiou Chung; Ng, Heung Tat.

In: Journal of the American Association of Gynecologic Laparoscopists, Vol. 8, No. 2, 2001, p. 267-271.

Research output: Contribution to journalArticle

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abstract = "Study Objective. To determine the safety and side effects that may be caused by laparoscopic-assisted uterine depletion (LAUD) of submucous myomas. Design. Retrospective chart review and follow-up (Canadian Task Force classification 11-2). Setting. University-affiliated tertiary referral center. Patients. Five hundred twenty women with symptomatic myomas warranting surgical treatment, who wished to retain their uteri. Intervention. Laparoscopic bipolar coagulation of uterine arteries and anastomotic sites of uterine arteries with ovarian arteries. Measurements and Main Results. Postoperative sonographs showed submucous myomas in 53 (10.2{\%}) women. During follow-up for a mean of 8.6 months very few complications occurred; however, nine women (1.7{\%}) experienced vaginal expulsion of myomas from 2 weeks to 5 months postoperatively. Four of them were readmitted within 43 days with high fever and fetid discharge, and cervical cultures revealed heavy growth of Escherichia coli in three. Vaginal myomectomy was performed in six patients, and one woman passed the myoma spontaneously. Histopathologic studies of these nine specimens showed that two had infarction, three had coagulative necrosis, and four had degeneration. After treatment, all nine women had normal menstruation and their symptoms resolved during follow-up of at least 3 months. Conclusion. In our experience LAUD led to satisfactory symptomatic improvement and reduction in myoma volume and few complications. If vaginal expulsion of submucous fibroids can be viewed as a side effect, we should pay close attention to women with submucous myomas, especially within 2 months of LAUD. Otherwise, more dangerous complications could occur.",
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