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Myomectomy During Cesarean Section: Why Do We Abstain From?

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Abstract

Objectives

To assess the intra- and postoperative results of cesarean myomectomy.

Methods

A retrospective study was conducted to collect the results of cesarean myomectomy procedures performed in our tertiary center between June 2013 and December 2018. The subjects were 2219 pregnant women undergoing cesarean section at these units.

Results

A total of 2219 scheduled patients undergoing CS were included in the present study. Sixty-five patients have undergone intramural myomectomy during CS; 82 patients have had subserosal myomectomy during CS. No statistically significant differences were found between the three groups in changes of preoperative Hb, postoperative Hb, mean Hb and length of hospital stay. Operation times were significantly longer in both intramural and subserosal myomectomy groups (45.23 ± 8.498 vs. 39.02 ± 6.824 vs. 32.14 ± 5.423 min, p 0.01). Only in the intramural myomectomy group, two patients were subjected to blood transfusion (3%). Assessment of intramural myomectomy patients was carried out by taking 5 cm as the cutoff value. No statistical differences were found between the two groups in terms of mean Hb change, operation time, length of hospital stay. In the group with intramural myomectomy larger than 5 cm, two (15.38%) patients needed a blood transfusion.

Conclusions

Cesarean myomectomy operation performed by experienced surgeons has no adverse effects other than lengthening the duration of operation and can be safely implemented.

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Acknowledgment

None.

Funding

During this study, no financial or spiritual support was received neither from any pharmaceutical company that has a direct connection with the research subject, nor from a company that provides or produces medical instruments and materials which may negatively affect the evaluation process of this study.

Author information

AEG and MTM took part in idea/concept; MFK and ZÇDG contributed to design; MTM and AEG involved in control/supervision; AEG and ZÇDG took part in data collection and/or processing; MTM and MFK involved in analysis and/or interpretation; MFK and AEG contributed to literature review; AEG and MFK took part in writing the article; MTM contributed to critical review; ZÇDG involved in references and fundings.

Correspondence to Mehmet Ferdi Kinci.

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Conflict of interest

There is no conflict of interest between the authors and/or family members of the scientific and medical committee members or members of the potential conflicts of interest, counseling, expertise, working conditions, share holding and similar situations in any firm.

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Askın Evren Guler, MD Obstetrics and Gynecology Clinic, Koru Ankara Hospital, Ankara, Turkey; Zeliha Çiğdem Demirel Guler, MD Obstetrics and Gynecology Clinic, Koru Ankara Hospital, Ankara, Turkey; Mehmet Ferdi Kinci, MD Obstetrics and Gynecology Department, Muğla Sıtkı Koçman University Education and Research Hospital, Muğla, Turkey; Muhittin Tamer Mungan, Professor Obstetrics and Gynecology Clinic, Koru Ankara Hospital, Ankara, Turkey.

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Guler, A.E., Guler, Z.Ç.D., Kinci, M.F. et al. Myomectomy During Cesarean Section: Why Do We Abstain From?. J Obstet Gynecol India (2020) doi:10.1007/s13224-019-01303-6

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Keywords

  • Myoma uteri
  • Cesarean section
  • Myomectomy