Myomectomy at the Federal Medical Centre Gombe

The need to conserve the uterus, against all odds even when child bearing is complete makes conservative management of uterine fibroids quite appealing in our environment. Our objective is to document the prevalence, demographic characteristics and the outcome of patients who had myomectomy

All cases of myomectomy performed at the Federal Medical Centre Gombe between 1st January 2002 and 31st December 2004 were retrospectively reviewed. Only cases of histologically confirmed fibromyomata were included in the study. Fourty three (43) out of the 45 retrieved cases met the criteria for inclusion in the study. The age, parity Marital status, clinical presentation, and outcome were analysed using the EPI-INFO Version 6.0 statistical package.

There were 51 cases of myomectomy out of 581 major gynaecological surgeries giving an incidence of myomectomy of 8.8% for the period under study. The majority of the patients, 30 (69.8%) were aged between 30 and 39 years and 40 (93.0%) were of low parity. The commonest indication for myomectomy was infertility 18, (41.9%), followed by menorrhagia 12, (27.9%). The uterine size at presentation was greater than twelve weeks gestation size in 33, (76.7%) of the cases. Wound infection 6, (14%) was the commonest morbidity followed bypyrexia 3, (7%). About 10(23.3%) were single while 33 (76.7%) were married. Forty (93%) of the fibroids were located in the body of the uterus while 3 (7%) were cervical in location. Most 28 (65.1%) of the skin incisions were Pfannenstiel while 15 (34.9%) had midline subumbilical skin incision. Only 7 (16.3%) of the patients had blood transfusion. Of the 18 patients who complained of infertility, 6 (33%) had conceived.

Two thirds of the patients in this study presented with uterine masses greater than twelve week size, suggesting some delay in presentation. Liberal pelvic examination for women at risk of uterine fibroids may lead to early detection with consequent reduction in morbidity.