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- W2980583652 abstract "Video Objective The objective of this video was to present the use of uterine artery embolization prior to supracervical hysterectomy of a large fibroid uterus Setting A 40 year old woman, gravida 0, with a history of heavy menses, bloating, back pain and pelvic pressure presented to her primary care physician for symptomatic anemia and notable family history of fibroids. The patient reported a history of regular, monthly menses however noted an interval increase in her vaginal bleeding. Her past medical history was notable for anemia for which she was taking iron supplementation. She was found to have numerous large uterine leiomyomas on magnetic resonance imaging, with the largest measuring 12.6 centimeters on the anterior body of the uterus. Physical examination was notable for a 26cm, bulky uterus extending up to the liver edge and xiphoid process. The patient declined uterine artery embolization and Lupron as initial treatment for fibroids. She instead elected for definitive surgical management, and strongly desired a minimally invasive approach. Interventions Uterine artery embolization and ureteral stent placement immediately followed by laparoscopic supracervical hysterectomy, bilateral salpingectomy and cystoscopy with stent removal Conclusion This case is unique in its collaboration between interventional radiology, urology and gynecology to ensure the safest outcome for the patient. Use of uterine artery embolization immediately prior to laparoscopic hysterectomy for large uterine leiomyomas is beneficial in decreasing intraoperative blood loss and thereby improving visualization as well as decreasing morbidity during minimally invasive laparoscopic surgery. Furthermore, placement of ureteral stents intraoperatively allows identification of the ureters when pelvic anatomy is distorted by fibroid location and size. Distortion of pelvic anatomy can limit the use of a uterine manipulator but is not a contraindication to proceeding with minimally invasive technique." @default.
- W2980583652 created "2019-10-25" @default.
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- W2980583652 date "2019-11-01" @default.
- W2980583652 modified "2023-09-26" @default.
- W2980583652 title "Uterine Artery Embolization Prior to Laparoscopic Hysterectomy for a Large Fibroid Uterus" @default.
- W2980583652 doi "https://doi.org/10.1016/j.jmig.2019.09.772" @default.
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