Evaluating the feasibility and safety of vaginal myomectomy in China

Classically, myomectomy has been performed via laparotomy, but laparoscopic myomectomy has now become a valuable treatment option. Vaginal myomectomy as a minimal invasive procedure has also been evaluated; however, its feasibility and safety are controversial with few clinical trials published. This study was designed to evaluate the feasibility of vaginal myomectomy in China and to document any associated complications.

From January 2005 to December 2010, 43 patients with symptomatic myomas were admitted for vaginal myomectomy in Peking Union Medical College Hospital (PUMCH). The indications, operative performance, postoperative complications and outcome of these patients were analyzed retrospectively.

Myomectomy was performed vaginally in all patients. The mean operating time was (66.4 ± 22.6) minutes and the mean operative blood loss and hospital stay were (78.3 ± 64.4) ml and (4.9 ± 3.3) days, respectively. Five (12%) patients developed febrile morbidity and experienced a high postoperative temperature (mean 38.4°C). Postoperative fever was associated with greater operative trauma, longer operative time and greater weight of the tumor (all P < 0.01). The cost of surgery was RMB (820.6 ± 339.1) Yuan ((124.3 ± 51.4) US dollars) and the total medical cost was RMB (4880.4 ± 1088.4) Yuan ((739.5 ± 164.9) US dollars). Three patients later conceived spontaneously and had uneventful vaginal deliveries. Only one patient had a tumor recurrence during the following-up period.

Vaginal myomectomy is a feasible and safe surgical procedure with low recurrence and complication rates.