Management of uterine fibroids in Enugu, Nigeria

A 5-year review of management of uterine fibroids at the university of Nigeria Teaching Hospital Enugu revealed that symptomatic uterine fibroids constituted 9.8% of all gynaecological admissions. The peak incidence n = 51 (26.8%) was in the age range of 31 - 35 years and the majority of the women n = 77 (40.5%) were nulliparous. The main clinical features were lower abdominal discomfort, menorrhagia and associated infertility. There was no medical management. The surgical management consisted of myomectomy by laparotomy (60%); total abdominal hysterectomy (24.7%); total abdominal hysterectomy and bilateral salpingo-oophorectomy (12.1%), and polypectomy (3.2%). There was no endoscopic surgery available. Postoperative morbidity was high but there was no mortality. Uterine fibroids mostly managed by myomectomy at laparotomy remains a major public health problem in Enugu Nigeria.