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Laparoscopic Intracapsular Myomectomy in Women 40 Years Old and Over with Symptomatic Uterine Fibroids. A Pilot Study
- Source :
- The Surgery Journal, Vol 07, Iss 01, Pp e47-e53 (2021), The Surgery Journal
- Publication Year :
- 2021
- Publisher :
- Thieme Medical Publishers, Inc., 2021.
-
Abstract
- Authors evaluated the impact of laparoscopic intracapsular myomectomy (LIM) in women 40 years of age and over with desire of future fertility compared with medical management of symptomatic fibroids, by a prospective cohort study in University affiliated Hospitals. This study includes a cohort of women 40 years of age and older with symptomatic intramural fibroids with desire of future fertility. Women with symptomatic fibroid uterus were offered to undergo LIM or medical management. They were encouraged to attempt conception either spontaneously or by assisted reproductive technology (ART) according to their individual preference. All women were followed for 2 years. Fibroid characteristics, pre- and post-surgical variables, including surgical complications, days of hospitalization, pregnancy rate, and obstetrical outcomes were collected. A total of 100 patient were included in the analysis. Fifty patients were assigned to the LIM group and 50 to the medical treatment group (MT). Groups were similar regarding age (43.5 ± 2.4 and 43.5 ± 2.4, p = 0.99), body mass index (23.8 ± 3.1 and 24.2 ± 3.1, p = 0.54), parity (0.46 ± 0.09 and 0.58 ± 0.09, p = 0.37), fibroid number (1.38 ± 0.6 and 1.46 ± 0.6, p = 0.53), and fibroid size (5.92 ± 1.62 cm vs. 5.94 ± 1.49 cm, p = 0.949). Of the patients who underwent LIM, 62% conceived within the study period compared with 56% in the control group (p = 0.54). Pregnancy was achieved by ART in 44% of the patients of the LIM group and 30% in control group. There was no significant difference in pregnancy rates among the two groups regarding spontaneous pregnancy rate (p = 0.332), nor in pregnancies obtained by ART with own eggs (p = 0.146) and oocyte or embryo donation (p = 0.821). The take home baby rate was 65% (20/31) in the LIM group and 61% (17/28) in the control group (p = 0.7851). Both groups had similar rate of miscarriage (p = 0.748).Patients 40 years old and over with symptomatic fibroid uterus who undergo LIM have similar subsequent fertility and obstetrical outcomes than women treated with medical management. LIM has no detrimental impact on future fertility in women 40 years old and over.
- Subjects :
- medicine.medical_specialty
Uterine fibroids
reproductive outcome
medicine.medical_treatment
media_common.quotation_subject
lcsh:Surgery
menopause
Fertility
myoma pseudocapsule
Miscarriage
03 medical and health sciences
0302 clinical medicine
medicine
laparoscopic myomectomy
030212 general & internal medicine
uterine ageing
Prospective cohort study
media_common
2. Zero hunger
Pregnancy
030219 obstetrics & reproductive medicine
Assisted reproductive technology
Obstetrics
business.industry
lcsh:RD1-811
medicine.disease
3. Good health
Surgery
Pregnancy rate
Cohort
Original Article
pregnancy
business
Subjects
Details
- Language :
- English
- ISSN :
- 23785136 and 23785128
- Issue :
- 01
- Database :
- OpenAIRE
- Journal :
- The Surgery Journal
- Accession number :
- edsair.doi.dedup.....c22267a19bc4ea27e850b40a76231380