Laparoscopic Umbilico-uterine Trunk Clipping Approach in the Management of Enhanced Myometrial Vascularity

Inclusion criteria

• Confirmed diagnosis of Enhanced Myometrial Vascularity.
• Presence of clinical symptoms related to Enhanced Myometrial Vascularity: Such as menorrhagia affecting quality of life, or abnormal uterine bleeding (AUB) unresponsive to initial medical treatments.
• Women of reproductive age (18-45 years).
• Willingness to undergo surgical treatment: Participants must be willing to undergo one of the two surgical procedures under investigation (laparoscopic umbilico-uterine trunk clipping or Mirena Intrauterine Device Insertion).
• Written informed consent: Participants must be able to understand the study information and provide written informed consent to participate.
• Adequate general health to undergo anesthesia and laparoscopic surgery: This will be assessed by the responsible physician

Exclusion criteria

• Presence of other known causes of menorrhagia or abnormal uterine bleeding: Such as large uterine fibroids (> 3 cm in diameter, or with a location causing distortion of the uterine cavity), large endometrial polyps, untreated endometrial hyperplasia, or known bleeding disorders.
• History of extensive prior pelvic surgery: That may increase the difficulty or risks of laparoscopic surgery or significantly affect uterine blood supply.
• Current pregnancy or suspicion of pregnancy: Pregnancy testing will be performed before enrollment.
• Current breastfeeding.
• Presence of contraindications to general anesthesia or laparoscopic surgery: This will be assessed by the anesthesiologist.
• Severe, unstable systemic diseases: Such as uncontrolled cardiovascular disease, pulmonary disease, renal disease, or liver disease.
• Receiving hormonal therapy that affects the menstrual cycle or uterine blood flow.
• Participation in another clinical trial that could interfere with the outcomes of this study.
• Inability to comply with study procedures or follow-up.
• Any other condition that the principal investigator deems would compromise the safety of the participant or affect the study outcomes.