Document Detail


Laparoscopic occlusion compared with embolization of uterine vessels: a randomized controlled trial.
MedLine Citation:
PMID:  17197583     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare clinical outcome 6 months after treatment with bilateral laparoscopic occlusion of the uterine artery versus uterine leiomyoma embolization. METHODS: Sixty-six premenopausal women with symptomatic uterine leiomyomata were randomized to treatment with either laparoscopic occlusion of uterine arteries or uterine leiomyoma embolization. The primary outcome was reduction of blood loss from pretreatment to 6 months postoperatively, measured by a Pictorial Bleeding Assessment Chart. Secondary outcomes included patients' own assessment of symptom reduction, postoperative pain assessed using visual analog scales, ketobemidone used postoperatively, complications, secondary interventions, and failures. RESULTS: Fifty-eight women were included; 6-month follow-up data were available for 28 participants in each group. The percentage reduction in Pictorial Bleeding Assessment Chart scores did not differ between the treatment groups (52% after uterine leiomyoma embolization and 53% after laparoscopy, P=.96). The study had 52% power to detect a 20% difference on the Pictorial Bleeding Assessment Chart. Fewer participants in the group treated with uterine leiomyoma embolization complained of heavy bleeding after 6 months (4% compared with 21%, P=.044). The postoperative use of ketobemidone was higher after uterine leiomyoma embolization (46 mg compared with 12 mg, P<.001). CONCLUSION: Both laparoscopic occlusion of uterine vessels and embolizaton of uterine leiomyoma improved clinical symptoms in the majority of patients. Participants with the laparoscopic procedure had less postoperative pain but heavier menstrual bleeding 6 months after treatment. A larger study and longer follow-up is necessary before a definite conclusion can be made regarding the most effective treatment. CLINICAL TRIAL REGISTRATION: (www.ClinicalTrials.gov), NCT00277680 LEVEL OF EVIDENCE: I.
Authors:
Kirsten Hald; Nils-Einar Kløw; Erik Qvigstad; Olav Istre
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  109     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-01     Completed Date:  2007-02-15     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  20-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Ullevål University Hospital, University of Oslo, Norway. khald@online.no
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00277680
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MeSH Terms
Descriptor/Qualifier:
Adult
Analgesics, Opioid / administration & dosage
Embolization, Therapeutic* / adverse effects
Female
Humans
Laparoscopy* / adverse effects
Leiomyoma / therapy*
Menorrhagia / therapy
Meperidine / administration & dosage,  analogs & derivatives
Middle Aged
Nausea / etiology
Pain, Postoperative / drug therapy
Pressure
Recovery of Function
Treatment Outcome
Uterine Neoplasms / therapy*
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 469-79-4/ketobemidone; 57-42-1/Meperidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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