What is the success rate of uterine artery ligation?
Uterine artery embolization and uterine artery ligation both have reported success rates of greater than 90% with low complication rates. If both techniques are available, embolization is the preferred first choice as it obviates laparotomy, and ligation can be attempted subsequently if embolization is unsuccessful.
How do you ligate the uterine artery?
A large atraumatic (round) needle is used with a heavy absorbable suture. Include almost the full thickness of the myometrium to anchor the stitch and to ensure that the uterine artery and veins are completely included. The needle is then passed through an avascular portion of the broad ligament and tied anteriorly.
Which artery is first tied in PPH?
Uterine artery ligation is one of the most common surgical procedure for PPH as it is easy and quick.
Is uterine artery ligation first line?
When conservative management is feasible, the first line approach should be bilateral distal ligation of the uterine arteries: this simple and low-risk technique is immediately effective in 80% of cases.
Does uterine artery ligation affect fertility?
Conclusions: Uterine artery ligation, whether or not associated with utero-ovarian ligament ligation, for PPH does not appear to compromise the patients’ subsequent fertility and obstetrical outcome.
What is uterine packing?
Uterine packing should be considered as a presurgical management tool after lacerations of the lower genital tract, uterine rupture, or retained products have been ruled out and when conventional therapy fails to control uterine hemorrhage.
What are known complications of uterine Devascularization?
Result(s): Twelve months after uterine devascularization, the patient presented major intrauterine synechiae, absence of endometrium, and ovarian function failure. Conclusion(s): Uterine devascularization may be responsible for infertility as a result of intrauterine synechiae and ovarian function failure.
Can fibroids grow back after Uterine Fibroid Embolization?
Typically, however, the more fibroids a patient has, the less successful the myomectomy. Additionally, fibroids grow back several years after the surgery in 10 to 30 percent of cases.
Do you lose weight after Uterine Fibroid Embolization?
If you decide to have Uterine Fibroid Embolization, it is possible that you may lose some weight as your fibroid shrinks over time. Keep in mind that this is more likely to occur if you have large fibroids.
Is retroperitoneal dissection required for uterine artery ligation?
Retroperitoneal dissection to ligate the uterine artery at its vascular origin can circumvent these obstacles, resulting in a safer procedure. However, detailed anatomic knowledge of the course of the uterine artery and understanding of vascular variations are essential for optimal dissection.
What is uterine inversion?
INTRODUCTION Uterine inversion occurs when the uterine fundus collapses into the endometrial cavity, turning the uterus partially or completely inside out. It is a rare complication of vaginal or cesarean delivery, but when it occurs, it is a life-threatening obstetric emergency.
Ligation of the uterine arteries or hypogastric arteries may be performed; both operations require laparotomies. Bilateral hypogastric artery ligation has a success rate ranging from 40 to 100%. In contrast, uterine artery ligation has been shown to have a success rate of 92% and a complication rate of 1%.
Where is the ligation of the uterine artery?
Uterine artery can be ligated at the origin of the artery, or lateral to where it crosses over the ureter, or just at the level of internal os where uterine artery gives of ascending branch and cervical branch just beside the uterus.
Can a laparoscopic myomectomy cause uterine artery ligation?
This technique which resulted in reduced intraoperative blood loss and increases the success rate of laparoscopic surgeries. Laparoscopic uterine artery ligation can also be done in association with laparoscopic myomectomy, or just laparoscopic uterine artery ligation (LUAL) in symptomatic fibroid.
Which is better ligation or coagulation in hysterectomy?
Ligating the uterine artery is better than coagulation because most of the injuries during hysterectomy are due to thermal spread injuries at the level where ureter is crossed by the uterine artery. Thermal spread of bipolar is 6mm.Normally the uterine artery is 2 cm away from the ureter at the level of internal os.
