Can we consider cesarean myomectomy as a safe procedure without long-term outcome?

Akkurt M. O., Yavuz A., Yalcin S. E., Akkurt I., Turan O. T., Yalcin Y., ...More

JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE, vol.30, no.15, pp.1855-1860, 2017 (SCI-Expanded) identifier identifier identifier


Aim: To investigate short- and long-term outcomes in women undergoing cesarean myomectomy (CM).Methods: This was a retrospective study that explored short-term outcomes of women, who underwent cesarean operations with or without myomectomies (CM controls) in a single tertiary center throughout a 6-year-period. For long-term outcomes, the mean duration of follow-up was 6.31.0 years.Results: There were no differences among the CM (n=91) and control groups (n=60) considering mean change in hemoglobin and hematocrit levels, hemorrhage, as well as requirement for blood transfusions with a slightly increased operative time. Multiple myomas, and cervical and cornual localization were associated with an increased drop of hemoglobin and hematocrit (p<0.05). Subsequent pregnancy and recurrence rates were 35% (32/91) and 5.5% (5/91), respectively. Preterm delivery (n=1, 3.1%), uterine dehiscence (n=1, 3.1%), placenta previa (n=1, 3.1%) and mild-to-severe post-CM adhesions (n=8, 25%) were observed in subsequent pregnancies. Recurrence was identified in five of the nonpregnant (5.5%) women, and three of these (4.1%) underwent an additional major surgery. There was no recurrence in subsequent pregnancies.Conclusion: The recurrence of myoma was relatively low following CM. Subsequent pregnancy is protective for recurrence of myoma without increased adhesion formation and obstetric complications.