Conservative surgical abdominal treatment of uterine myoma: Recurrence and fertility

Background: the aim of the study is to evaluate limits, complications, relapses, subsequent fertility and outcome of pregnancy after abdominal myomectomy. Methods: retrospective study from January 1995 to December 1998, including 185 patients having had abdominal myomectomy. Mean follow-up was 58 months (range, 36-72). Results: 444 myomas were removed by abdominal myomectomy. The average duration of surgery was 82±89 min (range, 30-320); the average blood loss was 328±230 ml (range, 50-1350); the average drop in heamoglobin was 1.9±1.2 gr/dl. The average length of hospital stay was 4 days (range, 3-7). No intra-operative complications were encountered. Main postoperative complications were: 3 cases of abdominal wall haematoma, 2 severe hemorrhage recurrences (average drop in Hb 2.17±1.57). Hyperpirexya occurred in 36 patients (19.4%). Cumulative recurrence rate after myomectomy was 30% (n=41). 58 patients out of the 185 (31%) having undergone myomectomy desired pregnancy, including 19 patients with other minor infertility factors in addition to myomas. 42 patients out of the above 58 (72.4%) became pregnant, allowing 33 deliveries and 9 missed abortion. The pregnancy rate in patients presenting other minor infertility factors beside myomas was 47% (n=9). No case of uterine rupture during pregnancy was observed. Conclusions: abdominal myomectomy has proved to be an effective and safe tecnique. It shows a very low rate of complications as well as a very good outcome concerning fertility.