Intraoperative Optical Diagnostics of Uterine Microcirculation during Myomectomy

Previous studies have shown that intraoperative optical diagnostics can be used to solve fundamental and applied problems in gynecology. Our article presents results from experimental in vivo intraoperative measurements of endogenous fluorescence and blood perfusion in various sections of the uterus, myometrium, endometrium, myomas, and pseudocapsule in female patients undergoing myomectomy. We found that myomas have different blood supply and fluorescence level at wavelength 365 nm depending on their growth intensity and size, most likely due to collagen accumulation in the extracellular matrix and changes in the vascular architecture. The possibility of laser Doppler flowmetry to assess endometrial perfusion is also demonstrated for investigating the effect of myomas of different types on endometrial tissue blood supply. The results obtained can be used to provide a better understanding of pathological processes in uterine leiomyoma, thus helping physicians to choose treatment strategies.