An effective method using laparoscopy in treatment of upper vaginal leiomyoma.

Objective: To introduce an effective approach using laparoscopy in the treatment of upper vaginal leiomyoma.

Design: Step-by-step video explanation of the surgical procedure with still pictures and surgical video clips to demonstrate the detailed technique, approved by the Shengjing Hospital of China Medical University.

Setting: Hospital.

Patient(s): A 34-year-old woman diagnosed with 5-cm upper vaginal leiomyoma, who had sexual discomfort for 5 years.

Intervention(s): Using laparoscopy in the treatment of upper vaginal leiomyoma consists of five steps: first lysing the pelvic adhesion; exploring the pelvic cavity and locating the vaginal leiomyoma through gynecologic examination by the assistant; recognizing the position between leiomyoma and ureter and carefully dissociating ureter while avoiding injury; completely enucleating and resecting the vaginal leiomyoma using laparoscopy; and exploring the ureter, rectum, and uterine artery to make sure there was no injury.

Main Outcome Measure(s): Value and feasibility of using laparoscopy in treatment of upper vaginal leiomyoma.

Result(s): The vaginal leiomyoma was removed successfully using laparoscopic operation and the operative time was 95 minutes. In the follow-up period, the patient did not report any symptoms, and she became pregnant at the time of the 20th month after operation and underwent a vaginal delivery at full-term.

Conclusion(s): For upper vaginal leiomyoma treatment, laparoscopic operation could present a clear visual field to avoid injury of bladder, ureter, rectum, and uterine artery. Laparoscopic operation is safe and feasible in treatment of upper vaginal leiomyoma.