Premyomectomy Uterine Embolization Reduces Blood Loss and Operative Time and Preserves Fertility

Purpose: To evaluate if preoperative uterine embolization can reduce blood loss and operative time during laparoscopic myomectomy in patients who desire to preserve fertility

Materials and Methods: Retrospective study compared 49 patients who had uterine artery embolization with Gelfoam on the day of the myomectomy with 41 patients who had the same without embolization. The fibroid size, number, and their total volume based on the most recent imaging study were extracted. Intraoperative blood loss and operative time as well as any need for transfusion or conversion to hysterectomy in the two groups were recorded. T-test or Wilcoxon rank test was used accordingly.

Results: The embolized group had a mean fibroid volume of 527.6 ± 928.45 and a total volume of 1006.86± 1771.84 cm³. The mean number of fibroids in this group was 2.96± 2.84. In the nonembolized group, the mean volume was 540.17 ± 671.68, and the mean total volume measured 1030.86± 1281.84 cm³. The mean number of fibroids in this group was 3.96± 2.54. Mean blood loss in the embolized group was 326.81± 344.52 mL compared with 545.61± 3526.63 mL in the nonembolized group (P = 0.02). After adjusting by the size and number of fibroids, the difference shrunk (P = 0.12). The operative time in the embolized group was78.36± 42.24 min compared with 183.51± 51.51 min in the nonembolized group (P <0.0001).

Conclusions: Preoperative Gelfoam embolization of fibroids can significantly reduce operative time during laparoscopic myomectomy.