Use of three-dimensional ultrasonography in the evaluation of uterine perfusion and healing after laparoscopic myomectomy

Chang, Wen‐Chun; Chang, Daw-Yuan; Huang, Su‐Cheng; Shih, Jin-Chung; Hsu, Wen‐Hao; Chen, Szu‐Yu; Sheu, Bor‐Ching

doi:10.1016/j.fertnstert.2008.07.1771

Cited by 37 publications

(18 citation statements)

References 30 publications

(43 reference statements)

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“…They concluded that the recovery process is complete at 12 weeks after the operation. Through a study demonstrated by 3‐D power Doppler ultrasound, Change et al . reached a similar point that by the third postoperative month the blood flow and uterine scar volume decreased significantly, which suggests good wound‐healing and dissolving of hematomas.…”

Section: Discussionmentioning

confidence: 97%

Pregnancy outcomes following different surgical approaches of myomectomy

Tian

Long

Dai

2014

J of Obstet and Gynaecol

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Section: Discussionmentioning

confidence: 97%

Pregnancy outcomes following different surgical approaches of myomectomy

Tian

Long

Dai

2014

J of Obstet and Gynaecol

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“…Cessation of bleeding and re‐bleeding of UAP might occur as a breakdown of spontaneous healing of hematoma. Hetero‐echogenic changes with thrombosis formation are seen in the healing process of hematoma as Figure 1c, followed by shrinkage of hematoma in most cases 16 . Pseudoaneurysms arise from disruption of arterial wall and their boundaries are formed by peripheral thrombus and soft tissue structures surrounding the injured vessel 12 .…”

Section: Discussionmentioning

confidence: 99%

“…Hematomas after myomectomy are sometimes observed in the process of uterine healing and perfusion. Although the formation of hematoma does not always precede the development of UAP, a larger hematoma might partly account for the increased possibility of UAP due to poor perfusion and delayed wound healing 16 …”

Section: Discussionmentioning

confidence: 99%

“…Hetero-echogenic changes with thrombosis formation are seen in the healing process of hematoma as Figure 1c, followed by shrinkage of hematoma in most cases. 16 Pseudoaneurysms arise from disruption of arterial wall and their boundaries are formed by peripheral thrombus and soft tissue structures surrounding the injured vessel. 12 Hematomas after myomectomy are sometimes observed in the process of uterine healing and perfusion.…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous cessation and recurrence of massive uterine bleeding can occur in uterine artery pseudoaneurysm after laparoscopically assisted myomectomy

Oishi¹,

Wada-Hiraike²,

Osuga³

et al. 2012

J of Obstet and Gynaecol

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A uterine artery pseudoaneurysm (UAP) is a rare but life-threatening complication that can occur after gynecologic surgery. Herein, we present a case of a 38-year-old woman who presented with massive uterine bleeding one month after a laparoscopically assisted myomectomy. Although the bleeding ceased spontaneously, a massive hemorrhage reoccurred three weeks thereafter, and a ruptured perfusion sac at the right uterine artery was identified by computed tomography angiography and ultrasonography. The patient was treated with transfemoral catheter embolization of the right uterine artery, and complete resolution of the UAP was successfully obtained. Our case suggests that a UAP may be a cause of unexplained repetitive metrorrhagia after myomectomy.

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“…In the authors' opinion, the main problem with these approaches is that their use could mask the musculature vascularization for vessel collapse, making selective and gentle pseudocapsule vessel hemostasis difficult during myomectomy and favoring successive intramyometrial hematomas, detected by ultrasound, 54,55 with impairment of the muscular healing at the hysterotomy site. On the contrary, during surgery, the fibroid pseudocapsule neurovascular bundle needs to be well exposed, by endoscopic magnification, and carefully protected, avoiding destructive procedures, such as large-scale diathermocoagulation at high wattage, favoring incorrect restoration of the uterine musculature.…”

Section: Introductionmentioning

confidence: 99%