Uterine artery occlusion and myomectomy for treatment of pregnant women with uterine leiomyomas who are undergoing cesarean section

Aim: To evaluate the efficacy of uterine artery occlusion and myomectomy (UAO+M) for pregnant women with uterine leiomyomas who are undergoing cesarean section (CS). Methods: Seventy-two women with uterine leiomyomas undergoing CS for obstetrical reasons were enrolled into this case-control study. Thirty-six patients underwent UAO+M during CS (UAO+M group), and 36 received CS alone (Control group). The UAO+M procedure was performed immediately after closure of the uterine incision wound. The outcome was measured by comparing surgical techniques, and future surgical intervention (myomectomy, uterine vessel occlusion or hysterectomy) for symptomatic leiomyoma. Results: The average follow-up time was 63 months. General characteristics of the patients were similar in both groups. There were no statistical differences in intraoperative blood loss, postoperative recovery, complications, or wound pain between the two groups. The operative time was significantly longer in the UAO+M group compared with that in the Control group, but the further surgical intervention rate was significantly lower in the UAO+M group than in the Control group (2.8% vs 41.7%, P <0.001). Seven patients (19%) in the UAO+M group and five (14%) in the Control group had a repeat CS during the follow-up period. Conclusion: UAO+M could be considered for treating pregnant women with uterine leiomyomas who are undergoing CS, compared with observation, as this procedure can minimize the necessity for future surgery, with increased operative time for the UAO+M procedure, but without increased surgical morbidity.