A multicenter randomized, controlled study comparing laparoscopic versus minilaparotomic myomectomy: reproductive outcomes
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Published on: January 17, 2019
Stefano Palomba1, Errico Zupi, Angela Falbo
1Department of Obstetrics & Gynecology, University Magna Graecia of Catanzaro, Catanzaro, Italy. stefanopalomba@tin.it
Objective:
To assess the reproductive outcomes after minilaparotomic and laparoscopic myomectomy in patients wishing to conceive.
Design:
Randomized controlled trial.
Setting:
Departments of obstetrics and gynecology of the universities of Catanzaro, Rome, and Florence, Italy.
Patient(S):
One hundred thirty-six women with symptomatic uterine leiomyomas or unexplained infertility.
Intervention(S):
Laparoscopic and minilaparotomic myomectomy.
Main Outcome Measure(S):
Pregnancy, abortion, and live-birth rates.
Result(S):
Between the laparoscopic and minilaparotomic groups no difference was observed in cumulative pregnancy, live-birth, and abortion rates, whereas pregnancy and live-birth rates per cycle, and time to first pregnancy and live-birth were significantly higher in the laparoscopic than in the minilaparotomic group. Categorizing the patients according to surgical indication for myomectomy, cumulative pregnancy rate, pregnancy, and live-birth rates per cycle, and time to first pregnancy and live-birth were significantly better after laparoscopic myomectomy in symptomatic patients, whereas all reproductive outcomes were similar between the two groups in patients with unexplained infertility.
Conclusion(S):
Minilaparotomic and laparoscopic myomectomy improves in a similar manner the reproductive outcomes in patients with unexplained infertility, whereas the laparoscopic approach provides the best benefits in fertile patients with symptomatic leiomyomas.
