Surgical Treatment of Uterine Leiomyomas from 2016-2022 in the Republic of Kazakhstan

Abstract

Background: Due to the transition to a mandatory health insurance system (MHIS) and also taking into account the impact of the COVID-19 pandemic, the purpose of this study was to evaluate the surgical treatment of uterine leiomyoma in Kazakhstan in recent years, taking into account the ratio of uterine-preserving surgery (UPS) and hysterectomy. Methods and Results: This epidemiological study was carried out upon the request of the Republican E-Health Center (RCEZ) to assess the dynamics of surgical treatment of uterine leiomyomas (UL) in Almaty at the expense of the Republican budget from 2016 to 2022. Since 2016, by 2022 there was a decrease in the total number of treated cases of UL at the expense of the Republican budget (from 1,478 to 1,063). From 2016 to 2019, there were statistically significantly more hysterectomies, whereas from 2020 to 2022 the number of uterine-preserving surgeries increased statistically significantly. The number of laparoscopic myomectomy and hysteroscopic myomectomy for treating submucous leiomyomas increased statistically significantly from 2016 to 2019. However, there were no statistical differences in the number of treated cases with this technique from 2020 to 2022. Conclusion: Although high-tech fibroid surgery has been performed more frequently in recent years, these numbers are insufficient today, which justifies the need to train more specialists in advanced technologies.