Gravid uterine rupture after myolysis

Advances in endoscopic surgical capabilities have influenced the management of a number of common gynecologic conditions. However, the advantages of lessening perioperative discomfort and hospitalization must not eclipse consideration of the long-term outcome. Myolysis, the laparoscopic coagulation of uterine leiomyomas, has been presented as an efficient treatment of symptomatic uterine smooth-muscle tumors. This procedure involves destruction of tissue via bipolar cautery transmitted through a pair of needles inserted into a leiomyoma. No excision or suturing of tissue is performed. In a MEDLINE search for articles on bipolar coagulation myolysis, no reports on the reproductive performance of the uterus after myolysis were found. We report one case of late second-trimester uterine rupture that occurred after myolysis performed several months before conception.