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Myomectomy: technique and current indications.

L Wong1, J L Brun

  • 1Department of Obstetrics and Gynecology University Hospital Pellegrin, Bordeaux, France - jean-luc.brun@chu-bordeaux.fr.

Minerva Ginecologica
|February 27, 2014
PubMed
Summary
This summary is machine-generated.

Myomectomy is a surgical option for women with uterine fibroids who want to preserve fertility. Only removing submucosal fibroids consistently improves fertility outcomes.

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Area of Science:

  • Gynecology
  • Reproductive Medicine
  • Surgical Oncology

Background:

  • Uterine fibroids are common benign tumors affecting reproductive-aged women.
  • Fibroids can cause heavy bleeding, pelvic pressure, and impact fertility.
  • Myomectomy is a surgical option for fertility preservation, but its reproductive benefits are debated.

Purpose of the Study:

  • To review surgical approaches for myomectomy.
  • To discuss evidence-based indications for myomectomy in women with fibroids.
  • To analyze the impact of myomectomy on reproductive outcomes and fertility.

Main Methods:

  • Critical literature review of surgical approaches for myomectomy.
  • Analysis of indications for myomectomy.
  • Focus on impact on fertility and reproductive outcomes.

Main Results:

  • Myomectomy treats symptomatic fibroids and selected infertility cases.
  • Hysteroscopic resection is indicated for symptomatic submucosal fibroids.
  • Laparoscopic or open myomectomy may be used for intramural and subserosal fibroids.
  • Prophylactic myomectomy is not recommended for obstetrical complications or leiomyosarcoma prevention.
  • Only submucosal fibroid removal improves spontaneous fertility and ART outcomes.

Conclusions:

  • Myomectomy is beneficial for symptomatic fibroids and selected infertility.
  • Surgical approach depends on fibroid type, size, and number.
  • Fertility improvement is primarily linked to submucosal fibroid resection.