Myomectomy During Cesarean Section: Why Do We Abstain From?

Area of Science:

• Reproductive Medicine
• Gynecologic Surgery
• Obstetrics

Background:

• Uterine fibroids (myomas) are common, affecting reproductive-aged women.
• Cesarean myomectomy offers a potential solution for simultaneous fibroid removal and delivery.
• Data on the safety and outcomes of cesarean myomectomy is crucial for clinical decision-making.

Purpose of the Study:

• To evaluate the intraoperative and postoperative outcomes of cesarean myomectomy.
• To compare outcomes between different types of myomectomy (intramural vs. subserosal) performed during cesarean section.
• To assess the safety and feasibility of cesarean myomectomy.

Main Methods:

• Retrospective study of 2219 pregnant women undergoing cesarean section.
• Analysis of data from cesarean myomectomy procedures (intramural and subserosal) performed between June 2013 and December 2018.
• Comparison of preoperative/postoperative hemoglobin, operation time, and hospital stay across groups.

Main Results:

• No significant differences in hemoglobin levels or hospital stay were observed between cesarean myomectomy and control groups.
• Operation times were significantly longer for both intramural and subserosal myomectomies compared to cesarean section alone.
• A small percentage of intramural myomectomy patients (3%) required blood transfusion, with a higher rate (15.38%) for those with fibroids larger than 5 cm.

Conclusions:

• Cesarean myomectomy can be safely performed by experienced surgeons.
• The primary adverse effect is an increased operation time.
• This combined procedure is a viable option for women requiring both cesarean delivery and myomectomy.