Vaginal myomectomy for subserosal and intramural fibroids

Abstract

Our aim was to explore the feasibility and safety of vaginal myomectomy in patients with subserosal and intramural uterine fibroids. Between June 2007 and June 2011, 38 patients with subserosal and intramural uterine fibroids were offered vaginal myomectomy. We analyzed the indications, operative performance, postoperative complications, recovery and fertility follow-up (24 months) of the patients. Results. Vaginal myomectomy was successful in all cases. One of our patients (38 years old) developed pelviperitonitis along with vaginal cuff dehiscence 7 days after surgery, and required subtotal abdominal hysterectomy. None of the cases required conversion to laparotomy or laparoscopy. Uterus size varied between 6 and 12 gestational weeks. The number of resected myomas was restricted to a maximum of three per patient and their weight varied from 125 to 175 g per myoma. The mean operative time was 31.68 ± 5.27 min; the intraoperative blood loss was 112.36 ml ±70.76 ml and none of the patients required transfusions. Hospitalization was 2.34 ± 0.6271 days. One patient developed fever 48 hours after surgery but symptoms disappeared after a 5 day antibiotics regimen; 2 patients delivered full-term babies at 12 and 24 months after surgery, respectively. Conclusions. Vaginal myomectomy, a minimally invasive technique with minimal tissue injury, is a feasible, safe and well tolerated alternative to abdominal myomectomy for well selected cases. <br/><a href=