High Recurrence Rate of Uterine Fibroids on Transvaginal Ultrasound after Abdominal Myomectomy in Japanese Women

Abstract

Aim: To evaluate the recurrence rate of uterine fibroids (UF) after abdominal myomectomy and the risk factors for recurrences. Methods: In aretrospective study, transvaginal ultrasound examinations were performed in 135 women after abdominal myomectomy. The main outcome measures were cumulative UF recurrence rates after abdominal myomectomy. The Kaplan-Meier survival analysis was used to estimate the cumulative recurrence rate, and log-rank tests were applied to compare survival curves among different categorical groups of potential risk factors for recurrences. Results: The cumulative UF recurrence rates at 12 and 24 months after abdominal myomectomy were 12.4 and 46.0%, respectively. Women who had a history of previous myomectomy had a higher hazard of UF recurrence than women without such a history (hazard ratio 4.1, 95% confidence interval 1.20–13.6). The women having four or more UFs had a higher hazard than those who had less than four UFs (hazard ratio 3.7, confidence interval 1.41–9.88). After adjusting these variables to each other, the hazard ratio remained similar. Conclusions: The UF recurrence rate detected by transvaginal ultrasound after abdominal myomectomy was high, but did not require any additional surgery. Physicians need to consider the timing of the myomectomy, taking into account complications of pregnancy and infertility due to UF recurrence.

High-Intensity Focused Ultrasound (HIFU) in Uterine Fibroid Treatment: Review Study

“…Myomectomy can be performed on patients who wish to retain their uterus, but cumulative uterine fibroid recurrence rates at 12 and 24 months after abdominal myomectomy are 12.4% and 46%, respectively [59]. The need for further surgery is high, and these surgical procedures are associated with morbidity in about 17% to 23% of cases [60].…”

“…Hysterectomy is the definitive treatment for uterine fibroids, since such benign tumors cannot recur after total uterus removal. However, this operation is unsuitable for patients wishing to remain fertile and possible sequelae, e.g., incontinence, vaginal vault prolapse, risk of premature ovarian failure, long recovery, high costs, justify serious consideration of alternative therapies such as HIFU [59,61]. Therapies such as uterine artery embolization (UAE) have been accepted as an effective alternative treatment for uterine fibroids rather than surgery, but various potential complications that may result from UAE have been reported.…”

High-intensity focused ultrasound tumor ablation: Review of ten years of clinical experience

“…However, this operation is unsuitable for patients wishing to remain fertile. Myomectomy can be performed on patients who wish to retain their uterus, but cumulative uterine fibroid recurrence rates of 12 and 24 months after abdominal myomectomy were 12.4% and 46.0%, respectively [33]. The requirement for further surgery is high, and these surgical procedures are associated with morbidity in about 17% to 23% of cases [34].…”

Laparoscopic ultrasound procedure can reduce residual myomas in laparoscopic myomectomy for multiple myomas

“…Nishiyama et al [4] reported that the recurrence rates at 12 and 24 months after abdominal myomectomy were 12.4 and 46.0 %, respectively. They also suggested that the presence of four or more myomas was a risk factor for recurrence after surgery [4].…”

“…They also suggested that the presence of four or more myomas was a risk factor for recurrence after surgery [4]. Furthermore, Malon et al [5] reported that the recurrence rate for uterine myomas within 5 years after the operation was 27 % in women who had a single myoma initially removed and was 59 % in women with multiple myomas initially removed.…”