Cervical Fibroids: the vaginal intracapsular myomectomy with classification by the fibroids' origin, growth directions and localizations

Abstract

This retrospective cohort observational study involved 15 patients who underwent cervical intracapsular myomectomy (CIM). The study aimed to assess the localization sites and sizes of cervical fibroids (CFs) and their impact on the feasibility of performing CIM using the vaginal approach. CFs originated from extra cervical-anterior-posterior localizations (EAPL) in six cases, extra-intracervical lateral locations (EILL) in five women, and combined cervical fibroids locations (CCFL) in two different sites in four patients. The most frequent cases were single CFs of EAPL or EILL, compared to CCFL. The localization or size of CFs did not substantially influence the safety and efficacy of the CIM technique, whether they occurred singly or in combination. The broader context of the findings of this study was estimated by comparative analysis of them with the outcomes of 1181 patients with CFs from the English and Chinese literature. The study identified the main issues of this problem that warrant attention, such as the original CIM technique performed through a direct vaginal approach and classifying CFs as growing and mature with comprehensive descriptions of their miscellaneous clinical manifestations depending on size, growth directions, localization sites, and depth of lesions. These findings may have implications for managing patients with CFs.