ACADEMIC AND RESEARCH PEER-REVIEWED MEDICAL JOURNALISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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Conservative Surgery for Uterine Leiomyoma

Bibliography link: Tarabanova O. V., Krutova V. A., Kovalenko Ya. A., Melkoniyants T. G., Bashirov E. V., Ordokova A. A., Titova A. N. Conservative Surgery for Uterine Leiomyoma. Doctor.Ru. 2017; 13(142)—14(143): 12–18.
19 December 00:00

Study Objective: To assess the effectiveness and safety of various myomectomy techniques and specific approaches to postoperative management of patients after uterine leiomyoma surgery for the purpose of restoring fertility.

Materials and Methods: Ninety-seven women of reproductive age undergoing myomectomy were included in the study. Surgery was performed using different techniques. Reproductive disorders were present in 32 patients (33.0%). Anti-müllerian hormone was measured to assess the patients’ ovary reserve, and the Short Form 36 Health Status Survey and Spielberger State-Trait Anxiety Inventory (Khanin's modification) were used to evaluate their emotional health. These assessments were done before and after surgery.

Study Results: Laparoscopic myomectomy was performed on patients with single or multiple subserous fibroids (43.3%); vaginal myomectomy on women who had fibroids on the low anterior or posterior uterine walls, cervical fibroids or cervical/isthmic fibroids (35.1%); laparotomic myomectomy on women who had multiple fibroids, large fibroids, intramuscular uterine myomas with centripetal growth, or intraligamentous fibroids (13.4%); and operative hysteroscopy on women with type 0 or 1 submucous fibroids measuring <5 cm (8.2%). Antimüllerian hormone levels before and after surgery were the same for all groups. In all cases there was statistically significant improvement in patients' mental and emotional health as well as their quality of life.

Ninety women (92.8%) planned to become pregnant during the first two years after surgery. Fifty-two of these women (57.8%) became pregnant spontaneously, and 38 women (42.2%) joined a program for in vitro fertilization with embryo transfer. Clinical pregnancy was diagnosed in 17.7% of these women.

Conclusion: The high rate of fertility restoration after surgery confirms that all current myomectomy techniques are highly effective. Treatment strategy should be chosen individually, taking into consideration the patient’s age and fibroid characteristics.

O. V. Tarabanova — Obstetric and Gynecological Teaching Hospital, Kuban State Medical University, Krasnodar. E-mail: ponotar@gmail.com

V. A. Krutova — Obstetric and Gynecological Teaching Hospital, Kuban State Medical University, Krasnodar. E-mail: vik-krutova@yandex.ru

Ya. A. Kovalenko — Obstetric and Gynecological Teaching Hospital, Kuban State Medical University, Krasnodar. E-mail: yanakovalenko.90@mail.ru

T. G. Melkoniyants — Obstetric and Gynecological Teaching Hospital, Kuban State Medical University, Krasnodar. E-mail: tatyanamelkonyanc@mail.ru

E. V. Bashirov — Obstetric and Gynecological Teaching Hospital, Kuban State Medical University, Krasnodar. E-mail: edikbashirov@rambler.ru

A. A. Ordokova — Obstetric and Gynecological Teaching Hospital, Kuban State Medical University, Krasnodar. E-mail: amnu.the.sun@gmail.com

A. N. Titova — Obstetric and Gynecological Teaching Hospital, Kuban State Medical University, Krasnodar. E-mail: antitnaftya@mail.ru

Доктор.ру
19 December 00:00
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