A COMPARATIVE STUDY OF LAPAROSCOPIC MYOMECTOMY WITH UTERINE ARTERY LIGATION AT ORIGIN VERSUS LAPAROSCOPIC MYOMECTOMY WITH INTRA-MYOMETRIAL VASOPRESSIN INJECTION.

Background: For Uterine broids, despite the higher level of technical competence needed to perform the treatment, laparoscopic ligation of the uterine vessels might be a better option than hysterectomy. The present study is aimed to compare two procedures laparoscopic myomectomy with uterine artery ligation at origin versus laparoscopic myomectomy with intramyometrial vasopressin injection in patients with uterine broid. Methodology: A Retrospective comparative study was conducted on 160 women of age between 22-45 years diagnosed as uterine broid from January 2020 to December 2022 (3 years). Patient divided into 2 groups: Group A: - 60 women who underwent Lap. myomectomy with LUAL, Group 2:100 women who underwent Lap. myomectomy with intra myometrial Vasopressin Injection. They underwent Trans Vaginal Sonography and Fibroid mapping for localization of position of broid. Results: The average blood loss was signicantly less and average operating time in Group A. Group A patients required almost 15mins more time for surgery. In addition, Group A only 3.3% required blood transfusions during or after the surgery. The symptom recovered much better in Group A compared. The recurrence rate of myomas in the Group B, who had laparoscopic myomectomy with intra-myometrial Vasopressin Injection, was higher than that in the LLUAL Group (Group A) (P<0.05). Furthermore, in the infertile patients 36.7% in the Group A and 31.3% in Group B had pregnancies and 27.5% in the Group A and 33.1% in Group B had a live birth but difference was not statistically signicant. Conclusion: Uterine artery ligation requires 15 min. more time. Less bleeding during temporary uterine artery ligation at origin allows more time of excision of myoma and clear eld of vision for tracing path of ureter, so there are less chances of injury to ureter.