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Title of the paper __ Does pre-surgical uterine artery embolization improves operability and outcome? Report of FIVE cases

Introduction- Combined approach of pre surgical UAE in myomectomy has demonstrated good results in some short term studies. The aim of our report is to assess the effect of pre operative UAE performed the day before the myomectomy.

Materials and methods - We undertook three cases of laparoscopic myomectomy a day after UAE. Both were nulliparous. The fibroid was single and 32 weeks in size in the first patient. The second had recurrent multiple large fibroids 24 weeks in size and previous history of two myomectomies. Two cases had associated adenomyomas.

Results- No technical failure or complication was encountered at UAE. Significant shrinkage in size was seen after 24 hours of the UAE.

At surgery minimal blood loss and good delineation of tissue planes was noted. Difficulties were faced with morcellation due to degeneration and softening. Friability of the overlying myometrium was observed in one patient.

Conclusions- Pre surgical UAE minimizes operative difficulties, blood loss and apparently reduces duration of surgery. Before making recommendations experience with more cases is required in terms of delineation of planes, enucleation, and suturing, morcellation, and blood loss, reconstructibilty of uterus and post operative outcomes.