Temporary preoperative uterine artery embolization (TP-UAE) combined with laparoscopic myomectomy can reduce hemoglobin drop and operation time

Study objective Analysis of the effect of temporary preoperative uterine artery embolization (TP-UAE) on perioperative parameters and long term outcome (risk of recurrence, health status, fertility) of laparoscopic myomectomy.

Method Monocentric retrospective cohort study at a tertiary care university hospital center. Data from patients who underwent laparoscopic myomectomy for therapy of uterine leiomyomas from January 2014 to March 2020 were collected.

Results 157 patients were included, of which consecutive 73 underwent laparoscopic myomectomy with TP-UAE and 84 without TP-UAE. Combination with TP-UAE resulted in significantly reduced operating time of myomectomy (138.60 min, 95% CI 128.64-148.57 min, compared to 171.67 min, 95% CI 154.02-189.32 min, p<0.001) and less perioperative hemoglobin change (0.86 mmol/l, 95% CI 0.75-0.97 mmol/l, compared to 1.65 mmol/l, 95% CI 1.50-1.81 mmol/l, p<0.001) while length of hospital stay showed no difference. Subgroup analysis revealed an even more pronounced benefit of TP-UAE in patients with myoma size larger than 6 cm. Operating time: 148.75 min, 95% CI 134.06-163.44 min, compared to 211.89 min, 95% CI 187.11-236.68 min, p<0.001. Perioperative hemoglobin change: 0.75 mmol/l, 95% CI 0.58-0.92mmol/l compared to 1.94 mmol/l, 95% CI 1.72-2.17 mmol/l, p<0.001. One patient in the TP-UAE group experienced mild complications attributable to local anesthesia required for embolization.

Conclusion Data of this study support the feasibility and safety, as well as the benefit of TP-UAE in combination with laparoscopic myomectomy. A prospective study is needed to proof these results and provide the basis for acceptance of the described strategy in daily clinical practice.

Publication History

Article published online:
11 October 2022