Predictors of myoma recurrence after myomectomy

Abstract

39. Predictors of Myoma Recurrence After Myomectomy MM Hanafi. Saint Joseph's Hospital of Atlanta, Atlanta, Georgia. Study Objective. To evaluate the factors associated with the recurrence of leiomyomata after myomectomy. Design. Retrospective analysis of 145 consecutive cases of abdominal myomectomy performed by a single surgeon. Setting. Gynecology practice affiliated with a tertiary care center in Atlanta, Georgia. Patients. One hundred forty-five women with uterine leiomyomata. Intervention. Abdominal myomectomy. Measurements and Main Results. Myoma recurrence, diagnosed by transvaginal ultrasound, was evaluated by life table analysis, log-rank tests, and Wilcoxon rank-sum tests according to clinical characteristics of patients. The 48-month cumulative recurrence rate was significantly lower in patients with a single myoma removed (41%), compared with patients with multiple myomas (56%; p =.031). Patients with childbirth after myomectomy also had a significantly lower cumulative recurrence rate at 48 months (0%), versus patients without subsequent childbirth (66%; p =.007). Patient age appeared to have a strong relationship with recurrence; the 48-month cumulative recurrence rate was 35 % in patients younger than 35 years, compared with 75% in patients over 39 years (p =.005). However, there was a strong association between age group and subsequent parity (p =.001). Conclusion. Subsequent parity, solitary myomectomy, and younger patient age were all associated with lower rates of myoma recurrence after myomectomy.