Outcome of abdominal myomectomy

ABSTRACT

To find out the results of in abdominal myomectomy in terms of complications and fertility. Study design. Place and Duration of study Jinnah Medical and Dental college and Hospital, Baqai Medical University and other private hospitals where author practiced from January 2003 to January 2009. The study included all women who underwent abdominal myomectomy. Indications for surgery were menorrhagia, abdominal mass, dyspareunia, infertility, repeated abortions and chronic pelvic pain. Patients who had endometriosis, adenomyosis, ovarian cyst and those whose spouse had abnormal semen analysis, patient not desirous for further pregnancies and malignancies were excluded. All patients had routine pelvic ultrasound and hysterosalpingogram before and after surgery. Morbidity such as intra operative blood loss, injury to adjacent viscera, trauma to the tubes, febrile morbidity, wound haematoma, infection, fertility, recurrence of myoma, adhesion formation were noted. All patients were followed at 3, 6 and 12 monthly interval. The analysis was performed by using SPSS version 10. Frequency and percentages were computed for presentation of all categorical variables. A total of 50 abdominal myomectomies were performed during the study period. Mean age of the patients was 36 years with parity of 0 -2. Duration of operation ranged between 60 - 90 minutes. Blood loss varied between 1800ml - 2500ml. Hospital stay was between 5-7 days. Fibroid size ranged between 5 - 7cm. Uterine cavity got opened in 5[10%] cases. In 10[20%] patients myomas had distorted the tubes bilaterally and trauma resulted during surgery. Febrile morbidity was noted in 7[14%] cases, vaginal discharge in 2[4%] and lower abdominal pain in 5[10%]. Uterine cavity of reduced size in 7[14%] patients and bilateral tubal blockage in 10[20%] cases were noted on hysterosalpingogram. At follow up two patients conceived at 12 months and one patient at 24 months. Abdominal myomectomy is a preferred treatment for women who want to become pregnant in future and is associated with fewer complications