Despite alternative methods such as embolization or leuprolide injections, myomectomy remains the “gold standard” for removing uterine fibroids, especially in younger women desiring pregnancy. Laparoscopic myomectomy offers a minimally invasive approach with the best chances for conception. However, post-operative adhesions and defects within the endometrial lining are still a risk. Thus, an ideal adjunct would promote endogenous regeneration of the tissue defect created by the surgery, minimize adhesions, and improve blood flow for future embryo implantation. We present for the first time use of viable, cryopreserved umbilical tissue (vCUT*, Stravix, Osiris Therapeutics, Inc.) in myomectomy. vCUT is ideal for prevention of adhesions and strengthening of the incised uterus due to its pro-regenerative, anti-fibrotic, angiogenic, and anti-inflammatory properties. vCUT contains all endogenous neonatal extracellular matrix proteins, growth factors, and tissue viable cells, including mesenchymal stem cells, in their native state.
Ten women underwent laparoscopic myomectomy. After fibroid removal the endometrium was closed with a monofilament suture, and vCUT was incorporated into the closure layer. Patients will be assessed at 3mo and 6mo post-op by 3D Doppler sonography for endometrial thickness and followed until time of conception and mandatory Cesarean delivery. At delivery, uterine anatomy and scarring will be assessed and, when possible, biopsies taken.
Preliminary data show all patients are healing well with minimal pain, no complaints, and no abnormal bleeding. Data collection is on-going for 3mo (n=5) and 6mo (n=5) outcomes.
Viable, cryopreserved umbilical tissue shows promise as a novel adjunct to support endometrial regeneration following laparoscopic myomectomy.