Temporary endovascular balloon occlusion of the bilateral internal iliac arteries for control of hemorrhage during laparoscopic-assisted myomectomy in a nulligravida with a large cervical myoma

Objective: To describe the preoperative evaluation and minimally invasive management of a large cervical myoma in a nulligravida who wished to preserve fertility. Design: Case report. Setting: Departments of obstetrics and gynecology and radiology at a general hospital. Patient(s): A 33-year-old nulligravida with a large cervical myoma. Intervention(s): A large cervical myoma was preoperatively diagnosed by ultrasonography, magnetic resonance imaging, and computed tomographic angiography and was successfully treated with minimal blood loss by laparoscopic-assisted myomectomy combined with prophylactic temporary endovascular balloon occlusion of the bilateral internal iliac arteries. Main Outcome Measure(s): Uterine conservation. Result(s): Fertility preservation was achieved with minimal blood loss in a nulligravida with a large cervical myoma. Conclusion(s): Laparoscopic-assisted myomectomy combined with prophylactic endovascular balloon occlusion of the bilateral internal iliac artery was an effective minimally invasive procedure to preserve fertility in a nulligravida with a large cervical myoma. (Fertil Steril (R) 2009;91:935.e5-e9. (C) 2009 by American Society for Reproductive Medicine.)