Laparoscopic Cervical Myomectomy with Pre-operative Uterine Artery Embolization and Concomitant Cerclage

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Video Description

Cervical myomectomy is a surgical challenge and the risk of subsequent cervical incompetence is unknown. We presented the case of a 30-year-old woman, nulligravida, with a 12 cm cervical leiomyoma, who consulted for heavy menstrual bleeding and pelvic pain.

After failure of multiple medical therapies, a laparoscopic cervical myomectomy was successfully performed. Adjuvant pre-operative uterine artery embolization with gelatin sponges was used to reduce surgical blood loss, as an alternative to intra-operative ligation of uterine arteries when access to the retroperitoneum is limited by the size and location of leiomyomas.

In order to prevent cervical incompetence, a concomitant laparoscopic cerclage was achieved since the integrity of the cervix has been compromised by the myomectomy.

Presented By

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Dr. Vanille Simon
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Dr. Marie-Eve Bergeron
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Dr. Philippe Laberge
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Dr. Sarah Maheux-Lacroix

Affiliations

Université Laval, Centre Hospitalier Universitaire de Québec