Myomectomy: A Reappraisal and Post‐Operative Reproductive Performance

Omu, Alexander E.; Ehigiegba, AE

doi:10.1111/j.1447-0756.1983.tb00602.x

Cited by 4 publications

(1 citation statement)

References 8 publications

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“…However a population based study did not find any evidence relating general abnormalities in menstrual cycle length or heaviness to the presence of uterine fibroids 10 .…”

Section: Discussionmentioning

confidence: 99%

Clinical Presentation & Operative Treatment of Leiomyoma of Uterus and its Outcome

Das

Jafrin

Biswas

et al. 2014

Chatt Maa Shi Hosp Med Coll J

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Introduction: Uterine leiomyoma is remarkably common, however only a subset of women have their fibroids clinically detected, symptomatic, or warrant surgical treatment. Mode of treatment depends on age of the patients, number, size and site of the myoma and also fertility status of the patients. Materials & methods: To evaluate the sociodemographic, clinical characteristics, management outcome and its determinants in BSMMU, Dhaka, Bangladesh, the study was carried out. 50 patients of diagnosed leiomyoma admitted in the BSMMU, Dhaka was selected for the study. Clinical profile, type of surgery and postoperative follow up findings were noted. Data was analyzed by computer based software SPSS -18. Results: The common complaints among the 50 patients were progressive menorrhagia (70%), abdominal swelling (50%), infertility (24%), weight in pelvis (38%), weakness/dizziness or syncopal attack after menstrual period (26%) and recurrent miscarriages (12%). The average uterine size at presentation was 15±9.7 weeks. The majority (70%) of the women presented with multiple leiomyomata. The commonest anatomical position of the myomas were multiple positions and intramural(80%). Total abdominal hysterectomy with or without bilateral sulphingo ophorectomy according to age was the commonest surgical procedure performed in thirty two (64%) cases. Myomectomy was done in 12(24%) cases and laparoscopic assisted vaginal hysterectomy was done in also 6(12%) of patients. Postoperative complications occurred in 24%(12) of the women. The most common complications were postoperative pyrexia 12%, blood loss warranting transfusion 8%, wound infection 10% and prolonged hospital stay 6%. Conclusion: Uterine fibroid is common in our environment and most of the patients had regular menstrual cycle with progressive menorragia. Its removal is commonly associated with post-operative pyrexia, blood loss, and anemia and wound infection. Preoperative correction of anemia appropriate use of antibiotics and strict hemostasis and asepsis can reduce these complications.

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“…However a population based study did not find any evidence relating general abnormalities in menstrual cycle length or heaviness to the presence of uterine fibroids 10 .…”

Section: Discussionmentioning

confidence: 99%

Clinical Presentation & Operative Treatment of Leiomyoma of Uterus and its Outcome

Das

Jafrin

Biswas

et al. 2014

Chatt Maa Shi Hosp Med Coll J

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Myomectomy

Miller¹

2000

Obstetrics and Gynecology Clinics of North America

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Abdominal myomectomy for infertility: a comprehensive review

Vercellini¹,

Maddalena²,

Giorgi³

et al. 1998

Human Reproduction

140

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To obtain estimates of the effect of abdominal myomectomy on infertility, information from studies published in the English language literature between 1982 and 1996 was retrieved. Articles were identified through hand and computerized searches using Medline. A total of 27 trials, all published in peer-reviewed journals, was identified, of which four were excluded from the analysis because of methodological limitations. All studies were non-comparative and only nine were prospective. The sample size was generally limited, the mean number of patients included being 49 and the mean number of infertile subjects 26. All patients were followed for at least 12 months after surgery in 12 studies. The combined estimate of pregnancy rates across prospective studies based on a total of 138 observed subjects was 57% [95% confidence interval (CI), 48-65%]. Time to conception varied from a mean of 8 to 20 months. Survival analysis was used in only three studies, with cumulative rates ranging from 57 to 67% at 1 year, and 63% at 5 years. The overall conception rate among seven prospective studies in which only women with otherwise unexplained infertility were recruited was 61% (95% CI, 51-70%) compared with 38% (95% CI, 20-59%) in two prospective studies that included patients with causes of infertility in addition to myomas (chi2(1) = 4.25, P = 0.04; mean difference = 23%, 95% CI, 1-43%; OR = 2.47, 95% CI, 1.03-5.94). The conception rate ranged from 58 to 65% in the three studies of women with only intramural and/or subserous fibroids and were respectively 53 and 70% in the two that considered only patients with submucous myomas. Data on recurrence after myomectomy were reported in 13 articles, with rates varying from 4 to 47%. According to the available evidence, slightly less than two-thirds of women with uterine leiomyomas and otherwise unexplained infertility conceived after myomectomy. However, comparison with expectant management is needed before drawing definitive conclusions on the effectiveness of this time-honoured conservative surgical procedure.

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Myomectomy: A Reappraisal and Post‐Operative Reproductive Performance

Cited by 4 publications

References 8 publications

Clinical Presentation & Operative Treatment of Leiomyoma of Uterus and its Outcome

Clinical Presentation & Operative Treatment of Leiomyoma of Uterus and its Outcome

Myomectomy

Abdominal myomectomy for infertility: a comprehensive review

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