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Background: Uterine arteries occlusion either laparoscopically or radiologically has become an alternative to hysterectomy treatment of symptomatizing uterine myomas. Despite these methods proved to be effective modalities of treatment, yet its mechanism of improving the symptoms have not been clearly identified. Objective: To assess the change of uterine and myoma volumes together with vascular change using 3Ds ultrasound with power Doppler after laparoscopic uterine arteries occlusion. Study design : Prospective clinical study Main outcome measures: The percentage reduction in the total uterine and myoma size, changes in the vasculature of the uterus and myomata and its correlation to the clinical response was evaluated. Results: From 40 patients recruited in the study 36 (90%) underwent technically successful! laparoscopic coagulation of the uterine vessels without intra operative complications. The main follow up time was 3,6,12 months. Symptomatic improvement occured in 88.9% and mass reduction in uterine and myoma volumes respectively was 64.6% and 78.8%. Also, there was a significant difference between pre and post operative power doppler study uterine vascular assessment among improved patients. Conclusion: Symptoms improvement occurs in laparoscopic uterine arteries occlusion is mainly correlated to changes in vascular supply to the uterus and myoma that lead to cell death or apoptosis which consequently reduces the myoma size and clinically improve the patient symptoms.

THREE DIMENSIONAL ULTRASOUND WITH POWER DOPPLER STUDY OF CHANGES IN UTERINE FIBROIDS AFTER LAPAROSCOPIC UTERINE ARTERIES OCCLUSION