Ultrasound evaluation of uterine healing after laparoscopic intracapsular myomectomy: an observational study

STUDY QUESTION Can uterine scar healing after laparoscopic intracapsular myomectomy (LIM) be adequately monitored by traditional two-dimensional (2D) ultrasound (US) and Doppler velocimetry? SUMMARY ANSWER The myometrial area of the scar after LIM can be followed by 2D US and Doppler velocimetry. WH...

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Bibliographic Details
Published in:Human reproduction (Oxford) 2012-09, Vol.27 (9), p.2664-2670
Main Authors: Tinelli, Andrea, Hurst, Bradley S., Mettler, Liselotte, Tsin, Daniel A., Pellegrino, Marcello, Nicolardi, Giuseppe, Dell'Edera, Domenico, Malvasi, Antonio
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Body Mass Index
Calibration
Cicatrix - therapy
Cohort Studies
Female
Gynecology. Andrology. Obstetrics
Humans
Laparoscopy - methods
Leiomyoma - complications
Leiomyoma - pathology
Leiomyoma - surgery
Medical sciences
Myometrium - diagnostic imaging
Myometrium - surgery
Prospective Studies
Time Factors
Ultrasonography, Doppler - methods
Uterus - diagnostic imaging
Uterus - surgery
Wound Healing
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Summary:STUDY QUESTION Can uterine scar healing after laparoscopic intracapsular myomectomy (LIM) be adequately monitored by traditional two-dimensional (2D) ultrasound (US) and Doppler velocimetry? SUMMARY ANSWER The myometrial area of the scar after LIM can be followed by 2D US and Doppler velocimetry. WHAT IS KNOWN ALREADY Apart from post-surgical adhesions, the main concern linked to laparoscopic myomectomy is the quality of healing of the myometrial incision: it has been suggested that US could be useful for assessing uterine scars after myomectomy. However, no diagnostic method has yet been widely accepted to assess the healing process. STUDY DESIGN, SIZE, DURATION A cohort prospective study (level of evidence II-2), run in University-affiliated hospitals: 149 women with symptomatic uterine fibroids (UFs) underwent LIM, between January 2007 and October 2011. During follow up 13 patients withdrew from the study. PARTICIPANTS/MATERIALS, SETTING, METHODS After LIM, all patients were followed by traditional 2D US scanning and Doppler velocimetry on Days: 0, 1, 7, 30 and 45. Authors evaluated: number, size and location of UFs, scar diameter and Doppler velocimetry and resistance index (RI) of the uterine arteries, at their ascending branch. MAIN RESULTS AND THE ROLE OF CHANCE The uterine examination showed a significant (P < 0.05) progressive reduction of uterine scar area from 78% of the previous UF location on the first day, to 19% on 30th day, and
ISSN:0268-1161
1460-2350
DOI:10.1093/humrep/des212