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.