Ageing impairs restoration of endometrial blood flow impedance after laparoscopic myomectomy in infertile women with uterine fibroids

Abstract

The aim of this study was to evaluate temporal changes in endometrial blood flow after laparoscopic myomectomy (LM). Nineteen infertile women with uterine fibroids who underwent LM were included. The uterine radial artery resistance index (RA-RI) and recovery index were measured before and at 1 week and 3 months after LM. The median RA-RI at 1 week but not 3 months after LM was significantly higher than before. The median recovery indexes at 1 week and 3 months after LM were 14.3% and 1.3%, respectively. Although there was no significant correlation between the patient’s age and recovery index at 1 week (r = 0.28, p = .24) after LM, a moderately significant correlation was observed at 3 months (r = 0.54, p = .002). In conclusion, the endometrial blood flow after LM changed over time, and recovery of blood flow was negatively correlated with patient age.

IMPACT STATEMENT

• What is already known on this subject? Uterine blood flow is important for wound healing after myomectomy, but no studies have evaluated endometrial blood flow after myomectomy.

• What do the results of this study add? The endometrial blood flow impedance of RA-RI increased after LM and returned to before surgery at 3 months postoperatively. RA-RI recovery index negatively correlated with patient age.

• What are the implications of these findings for clinical practice and/or further research? The changes in endometrial blood flow impedance after myomectomy suggest that endometrial blood flow may be involved in wound healing at the enucleation site. The impairment of endometrial blood flow recovery after myomectomy due to increased age may provide a rationale for individualised wound healing after myomectomy. The measurement of endometrial blood flow may be useful in personalising the assessment of the waiting period for pregnancy after myomectomy.

Keywords:

• Fibroid
• laparoscopic surgery
• myomectomy
• blood flow velocity
• wound healing

Acknowledgement

We thank Professor Hideki Mizunuma for his encouragement regarding this study.

Author contributions

K.O. and T.T. organised the study. K.O., K.S., and S.S collected the data. K.O. and T.T. analysed the data. K.O. drafted the manuscript. T.T. revised the manuscript.

K.O. drafted the manuscript. T.T revised the manuscript.

Disclosure of interest

The authors report no conflict of interest.

Additional information

Funding

This work was supported by a grant from The Japanese Foundation for Research and Promotion of Endoscopy.