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Myomectomy During Cesarean Section: Why Do We Abstain From?

Askın Evren Guler1, Zeliha Çiğdem Demirel Guler1, Mehmet Ferdi Kinci2

  • 1Obstetrics and Gynecology Clinic, Koru Ankara Hospital, Ankara, Turkey.

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Cesarean myomectomy, surgically removing uterine fibroids during cesarean birth, shows no adverse effects on patient recovery. While operation times increase, this procedure is safe when performed by experienced surgeons.

Keywords:
Cesarean sectionMyoma uteriMyomectomy

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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.