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Intrauterine adhesions after open myomectomy: an audit
Alessandro Conforti1, Geeta B Krishnamurthy1, Christos Dragamestianos1
1University Department of Obstetrics and Gynecology, Royal Free Hospital, Pond Street, Hampstead, London NW3 2QG, UK.
Objective:
To estimate the incidence of intrauterine adhesions after open myomectomy.
Study Design:
A prospective audit descriptive study was conducted involving thirty-six women who had undergone open myomectomy for symptomatic fibroids at a large undergraduate teaching hospital. A follow-up out-patient hysteroscopy was performed three months after surgery.
Results:
At hysteroscopy, eighteen patients (50%) were found to have mild to moderate intrauterine adhesions. The number of fibroids removed was significantly higher in patient who developed adhesions (median value 22 versus 9.5, p<0.05). Pre-operative GnRHa therapy, uterine size, opening of the uterine cavity during surgery, specimen weight, estimated blood loss, post-operative bleeding or pyrexia were similar whether or not adhesions were found.
Conclusion:
Open myomectomy represents an important but currently underappreciated aetiological factor in the formation of intrauterine adhesions.
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