Feasibility and safety of vaginal myomectomy:analysis of 90 cases

( views:71, downloads:0 )
WEI Feng-hua()
ZHAO Xiao-dong()
Journal Title:
Volume 119, Issue 21, 2006
Key Word:
uterine neoplasms;leiomyoma;surgical procedures, minimally invasive

Abstract: Background Vaginal myomectomy was firstly reported in 1994, however, it is a relatively new technique in China. The feasibility and safety of the procedure is still controversial in this country. The aim of this study was to analyze the outcomes of vaginal myomectomy in 90 patients and to investigate the feasibility and safety of the surgery.Methods From June 2001 to June 2004, 90 patients with uterine leiomyoma were treated with vaginal myomectomy in our hospital (vaginal group).. The indications, operative performance, postoperative complications, and recovery of the patients were analyzed and compared with those of 93 patients with uterine leiomyoma treated by laparotomic myomectomy from January 2000 to January 2001 (laparotomy group). The Student's t test was used to compare the continuous variables between the two groups, and the chi-square test was used to compare the categorical variables. The vaginal and laparotomy groups were followed up for 10-34 months (median, 21) and 15-24 months (median, 30), respectively.Results Vaginal myomectomy was performed successfully in 87 of the 90 patients (96.7%). In the other 3 patients, the procedure failed and laparotomy was carried out. In both groups, the uterus was enlarged to 8- 16 weeks gestational size (median, 10 gestational weeks). The number of resected tumors was 1-12 (median, 2) in the vaginal group and 1-15 (median, 4) in the laparotomy group, respectively (P>0.05). The mean operating time, intraoperative blood loss, and postoperative hospital stay were (52 ± 21) minutes, (230± 44) ml, and (7.0 ±1.2) days in the vaginal group, and (65±32) minutes, (200±56) mi, and (7.0±1.5) days in the laparotomy group (P>0.05). The mean top postoperative temperature was (38.4±1.1)℃ and (37.8±0.6)℃ in the two groups respectively (P<0.05). Both groups had one recurrent case during the follow-up (P>0.05).Conclusions Vaginal myomectomy is feasible and safe in treating uterine leiomyoma. To some extent, it is superior to laparotomic myomectomy by avoiding severe trauma during the surgery.

  • [1]Magos AL,Bournas N,Sinha R,Rechardson RE,O'Connor H.Vaginal myomectomy.Br J Obstet Gynecol 1994; 101:1092-1094.
  • [2]Davies A,Hart R,Magos AL.The excision of uterine fibroids by vaginal myomectomy:a prospective study.Fertil Steril1999; 71:961-964.
  • [3]Agostini A,Deval B,Birsan A,Ronda I,Bretelle F,Roger V,et al.Vaginal myomectomy using posterior.Eur J Obstet Gynecol Reprod Biol 2004; 116:217-220.
  • [4]Birsan A,Deval B,Detchev R,Poncelet C,Darai E.Vaginal and laparoscopic myomectomy for large posterior myomas:results of a pilot study.Eur J Obstet Gynecol Reprod Biol 2003; 110:89-93.
  • [5]Wang C J,Yen CF,Lee CL,Soong YK.Laparoscopic-assisted vaginal myomectomy.J Am Assoc Gynecol Laparosc 2000; 7:510-514.
  • [6]LaMorte Al,Lalwani S,Diamond MP.Morbidity associated at abdominal myometomy.Obstet Gynecol 1993; 6:897-900.
  • [7]Zhao XD,Zhang Y,Lu QB.Vaginal myomectomy-16 cases analysis.Natl Med J China (Chin) 2003; 38:46-47.
  • [8]Zhang J,Huang L,Chen YH.Clinical analysis of 45 cases of vaginal myomectomy.Chin J Obstet Gynecol (Chin) 2005; 40:659-661.
  • [9]Liu CX,Xie QH,Chen L.Clinical analysis of 50 cases of vaginal myomectomy.Chin J Obstet Gynecol (Chin)2002; 37:565-566.
  • [10]Jiao LX,Song L,Zhao EF.Clinical study of vaginal myomectomy.Chin J Obstet Gynecol (Chin) 2003; 38:307-308.
  • [11]Seracchioli R,Rossi S,Govoni F,Rossi E,Venturoli S,Bulletti C,et al.Fertility and obstetric outcome after laparoscopic myomectomy of large myomata:a randomized comparison with abdominal myomectomy.Hum Reprod 2000; 15:2663-2668.
  • [12]Dubuisson JB,Charpron C,Levy L.Difficulties and complications of laparoscopic myomectomy.J Gynecol Surg 1996; 12:159-165.
  • [13]Milad MP,Morrison K,Sokol A,Miller D,Kirkpatrick L.A comparison of laparoscopic supracervical hysterectomy vs.laparoscopically assisted vaginal hysterectomy.Surg Endosc 2001; 15:286-288.
  • [14]Nezhat CH,Nezhat F,Roemisch M,Seidman DS,Tazuke SI,Nezhat CR.Pregnancy following laparoscopic myomectomy:preliminary results.Hum Reprod 1999; 14:1219-1221.
  • [15]Dubuisson JB,Fauconnier A,Deffarges JV,Norgaard C,Kreiker G,Chapron C.Pregnancy outcome and deliveries following laparoscopic myomectomy.Hum Reprod 200; 15:869-873.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn