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[Myomectomy during cesarean section and outside pregnancy. Different outcomes of scars]
L Cobellis1, E M Messali, L Stradella
1Dipartimento di Ginecologia ed Ostetricia, Seconda Università degli Studi di Napoli, Naples, Italy. luigicobellis@yahoo.it
Background:
The purpose of this study is the comparison between the scar of myomectomy performed during cesarean section and out of the pregnancy.
Methods:
Eighteen pregnant patients were submitted to cesarean section between 37 and 39 weeks of gestation for previous myomectomy. The previous myomectomy has been performed in 8 patients during a cesarean section, in 10 patients out of pregnancy; in all patients only one subserous-intramural myoma of uterine fundus or body with a maximum diameter of 4-5 cm has been excised.
Results:
In myomectomies performed during cesarean section the scar appeared more linear, with good well defined limits, less wide and with modest introflection in comparison to surrounding myometrium. The myometrial thickness did not present variations and was well contracted.
Conclusions:
Our results show substantial differences: in fact, according to personal opinion, the different evolution of the healing process is due to variations occurring in pregnancy and particularly for local immunology system which in pregnancy is hyperactive. The presence and increased synthesis of immunological substances support a better healing with an optimal functional recovery.