Large uterus doesn't preclude abdominal myomectomy

April 1, 2006

Women with uterine fibroids equal to or larger than 16 weeks in size can be safely and effectively managed with abdominal myomectomy.

Women with uterine fibroids equal to or larger than 16 weeks in size can be safely and effectively managed with abdominal myomectomy.

Researchers evaluated 91 myomectomies performed for large fibroids during a 5-year period. They found mean operating time to be 236 minutes and mean estimated blood loss to be 794 mL. Seven women required homologous transfusion, one suffered a bowel injury, one experienced a bladder injury, one developed a wound infection, and one required surgery for an incarcerated small bowel. None of the women had a uterine sarcoma or adenocarcinoma, and none required conversion to hysterectomy.

Limitations of the research include lack of a control group, inclusion of only procedures performed by a single surgeon, and lack of confirmation of uterine size with ultrasound volume calculations. But the outcomes seem to compare favorably with those reported in studies of hysterectomies performed for uteri of similar size.