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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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Obstetrics and Gynegology2025№12

Characteristics of blood supply to uterine fibroids after laparoscopic myomectomy in history

DOI
https://dx.doi.org/10.18565/aig.2025.351

Dolgikh M.S., Polenov N.I., Yarmolinskaya M.I., Kogan I.Yu.

D.O. Ott Research Institute for Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia

Modern ultrasound technologies, including dynamic perfusion assessment, can deepen our understanding of the mechanisms that activate growth of residual uterine fibroids after myomectomy.
Objective: To evaluate the dynamics of blood supply to uterine fibroids remaining after laparoscopic myomectomy during 6 months of follow-up.
Materials and methods: A prospective cohort longitudinal study included 30 patients with a single uterine fibroid of intramural, intramural-subserous localization (FIGO type 4–5) that remained after laparoscopic myomectomy. We conducted a dynamic monitoring at 1, 3, and 6 months postoperatively, with the ultrasound assessment of biometry parameters and vascular morphology, as well as Doppler blood flow velocimetry. Three-dimensional ultrasound reconstruction with the VOCAL software was used to evaluate fibroid volume, echogenicity, as well as its vascularization indices (VI), flow index (FI), and perfusion index (VFI).
Results: We observed a decrease in uterine volume and restoration of endometrial thickness, accompanied by changes in the vascular architecture of the remaining uterine fibroids. The resistance index of the central fibroid vessels remained stable, while that of the peripheral vessels gradually increased. Small fibroids showed signs of angiogenic activity, while larger ones featured reduced perfusion. The perfusion index of uterine fibroids, both intramural (FIGO type 4) and intramural-subserosal (FIGO type 5), increased toward the end of the follow-up period; in type 4 nodules the enhancement of perfusion and flow index occurred earlier and was more pronounced than in intramural-subserosal nodules. Surgical factors had an impact on the perfusion indices of the residual uterine fibroids after myomectomy.
Conclusion: Size, location and type of the fibroid according to FIGO, as well as its surgical characteristics (number of removed fibroids, opening of the uterine cavity) were associated with differences in the perfusion indices of the residual uterine fibroids in postoperative observation. These data confirm that the combination of ultrasound features can be used for more substantiated planning of the frequency and extent of postoperative monitoring, but their prognostic role requires further study. 

Authors’ contributions: Dolgikh M.S., Polenov N.I., Yarmolinskaya M.I., Kogan I.Yu. – study conception and design; Dolgikh M.S., Polenov N.I. – data collection and processing; Dolgikh M.S. – manuscript composition; Kogan I.Yu., Yarmolinskaya M.I. – manuscript editing and critical revision. All authors have read and approved the final version of the manuscript.
Conflicts of interest: The authors declare no obvious or potential conflicts of interest regarding the publication of this article.
Funding: The study was supported by the research program "Development of a combined diagnostic method using optical biopsy in patients with benign tumors of the reproductive system (uterine fibroids) to enhance reproductive potential" 
(No. 1022040700754-2-3.2.2-1-9).
Ethical Approval: The study was approved by the Local Ethics Committee of the D.O. Ott Research Institute for Obstetrics, Gynecology and Reproductology (Protocol No. 1496 dated 12.09.2025). 
Patient Consent for Publication: The patients signed informed consent for the participation in the study and publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Dolgikh M.S., Polenov N.I., Yarmolinskaya M.I., Kogan I.Yu. Characteristics of 
blood supply to uterine fibroids after laparoscopic myomectomy in history.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (12): 98-110 (in Russian)
https://dx.doi.org/10.18565/aig.2025.351

Keywords

uterine fibroids
myomectomy
vascularization
VOCAL
ultrasound imaging
Full text (in Russian)

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Received 03.12.2025

Accepted 12.12.2025

About the Authors

Maria S. Dolgikh, MD, Junior Researcher at the Department of Gynecology and Endocrinology, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, 199034, Russia, St. Petersburg, Mendeleyevskaya Line, 3, mariadolgikh1@gmail.com, eLibrary SPIN: 3879-7773, Researcher ID: rid66760,
https://orcid.org/0000-0002-9910-9668
Nikolay I. Polenov, MD, PhD, Senior Researcher at the Department of Gynecology and Endocrinology, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, 199034, Russia, St. Petersburg, Mendeleyevskaya Line, 3, polenovdoc@mail.ru, eLibrary SPIN: 9387-1703, https://orcid.org/0000-0001-8575-7026
Maria I. Yarmolinskaya, Honored Scientist of the Russian Federation, Dr. Med. Sci., Professor of the Russian Academy of Sciences, Head of the Department of Gynecology and Endocrinology, Head of the Center of Diagnostics and Treatment of Endometriosis, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, 199034, Russia, St. Petersburg, Mendeleyevskaya Line, 3, m.yarmolinskaya@gmail.com, eLibrary SPIN: 3686-3605, Researcher ID: P-2183-2014, Scopus Author ID: 7801562649,
https://orcid.org/0000-0002-6551-4147
Igor Yu. Kogan, Dr. Med. Sci., Professor, Corresponding Member of the Russian Academy of Sciences, Director, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, 199034, Russia, St. Petersburg, Mendeleyevskaya Line, 3, ikogan@mail.ru, eLibrary SPIN: 6572-6450, Scopus Author ID: 56895765600,
Researcher ID: P-4357-2017, https://orcid.org/0000-0002-7351-6900
Corresponding author: Maria S. Dolgikh, mariadolgikh1@gmail.com

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