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Human Reproduction Update, Vol.6, No.6 pp.609-613, 2000
© European Society of Human Reproduction and Embryology 2000; all rights reserved

Laparoscopic myolysis

Jacques Donnez1, Jean Squifflet1, Roland Polet1 and Michelle Nisolle1

1 Département de Gynécologie, Université Catholique de Louvain, Cliniques Universitaires St Luc–UCL, Avenue Hippocrate 10, B-1200 Brussels, Belgium

To whom correspondence should be addressed at: Jacques Donnez, Département de Gynécologie, Université Catholique de Louvain, Cliniques Universitaires St Luc–UCL, Avenue Hippocrate 10, B-1200 Brussels, Belgium. Tel: +32-2-764 95 01; Fax: +32-2-764 95 07; e-mail: donnez{at}gyne.ucl.ac.be

Abstract

This review will focus on the different techniques and the long-term effects of the technique called myolysis on myoma growth. Indications for myolysis are essentially pelvic pain, compression symptoms and global uterine volume in order to avoid hysterectomy. In the late 1980s, myolysis was performed laparoscopically with the help of the neodynium: yttrium aluminium garnet (Nd:YAG) laser. Later, bipolar needles were developed as an alternative to the Nd:YAG laser. Diathermy and cryomyolysis were also proposed but series are small in the literature. Very recently, myoma interstitial thermo-therapy (MITT) was performed using the diode laser and a specific optical light diffuser that is designed to transmit laser light in all directions. Laparoscopic myolysis was proved to be effective in provoking myoma shrinkage, with a dramatic decrease in size and a marked devascularization of the myoma and this technique can be proposed as an alternative to myomectomy in selected patients: only those aged >40 years or those not desiring to bear any more children.

Key words: cryomyolysis / laser surgery / myolysis / myomata / thermo-therapy


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