Bilateral uterine artery ligation via minilaparotomy for heavy menstrual bleeding

Abstract 

Objective

To assess the safety and short-term efficacy of bilateral uterine artery ligation (UAL) via minilaparotomy for the management of heavy menstrual bleeding (HMB).

Methods

A prospective study of 30 women with HMB who underwent UAL. The primary outcome was cumulative treatment failure 12 months after the procedure. Treatment failure was defined as the need for hysterectomy during the follow-up period.

Results

At 12 months, 6 women had undergone hysterectomy for bleeding, for a cumulative failure rate of 20% (95% CI, 9%–38%). The number of bleeding days was significantly reduced by 11.9±1.5 days (P<0.001) and hemoglobin level significantly increased by 1.3±0.15 g/dL (P<0.001). Of the 30 women, 24 (80%) were satisfied with the results. No major complications were reported during the procedure or median follow-up period of 13.2 months.

Conclusion

Bilateral UAL is a safe and effective minimally invasive procedure that can provide an alternative treatment for HMB.

Keywords: Bilateral, Menstrual bleeding, Minilaparotomy, Uterine artery ligation, Uterine bleeding