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Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
Bilateral uterine artery ligation via minilaparotomy for heavy menstrual bleeding
Ibrahim M A Hassanin1, Ahmed Y Shahin, Ahmed T Abdel-Hafeez
1Department of Obstetrics and Gynecology, Faculty of Medicine, Sohag University, Sohag, Egypt.
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.
