The effect of myoma size on cesarean myomectomy results

Abstract

Objective: To investigate the effect of myoma size on intraoperative and postoperative outcomes in patients with cesarean section myomectomy. Materials and Methods: We retrospectively analyzed the data of 89 pregnant women who underwent cesarean section myomectomy in our tertiary center between 01 January 2016 and 01 January 2021. Study participants were divided into 2 groups according to fibroid size. Assessment of intramural myomectomy patients was carried out by taking 5 cm as the cutoff value. Maternal age, gestational age, neonatal weight, fibroid characteristics, pre- and postoperative hemogram values, operation time and transfusion need were compared between the two groups. Results: Sixty-five women with myoma size ≤5 (Group-1) and 24 women with myoma size >5 (Group-2) underwent cesarean section myomectomy. There was no statistically significant difference between the two groups in terms of pre- and post-operative hemoglobin (hb), mean hb values, operation time and hospital stay. The most common fibroids in this study were subserosal fibroids (77.5%) located on the anterior uterine wall (56.1%) with a diameter of 2 to 5 cm (70.7%). The mean number of myomas was 1.3±2.4. In the subgroup analysis, no significant difference in patient outcomes was found between intramural and subserous myomectomy. Only two patient (1.72%) with intramural myomectomy greater than 5 cm required blood transfusion. Conclusion: Cesarean section myomectomy performed by experienced surgeons can be performed as a safe and effective method in selected patients regardless of fibroid size. Moreover, fibroid has a wide spectrum of patients in terms of number, localization, size and patient characteristics. Therefore, treatment should be individualized.