Comparison of Clinical and Reproductive Outcomes between Adenomyomectomy and Myomectomy
| Autor: | Zdenka Lisa, Michal Mara, Barbora Boudova, Adela Richtarova, David Kuzel, Kristyna Hlinecka |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
media_common.quotation_subject Fertility Group B Miscarriage Pregnancy Uterine Myomectomy medicine Humans Adenomyosis Retrospective Studies media_common Leiomyoma Obstetrics business.industry Obstetrics and Gynecology Myoma Retrospective cohort study medicine.disease Pregnancy rate Treatment Outcome Uterine Neoplasms Female Laparoscopy business |
| Zdroj: | Journal of Minimally Invasive Gynecology. 29:392-400 |
| ISSN: | 1553-4650 |
| DOI: | 10.1016/j.jmig.2021.10.005 |
| Popis: | Study objective Women with adenomyosis may show a lower pregnancy rate and a higher miscarriage rate than healthy women. There is also a general agreement that leiomyomas, either submucosal or intramural, negatively affect fertility, when compared with women without fibroids. Some of these women may benefit from adenomyomectomy, however this cytoreductive procedure is considered invasive and technically challenging especially in severe diffuse cases. The study aimed to compare the clinical and reproductive outcomes of patients who underwent adenomyomectomy with those of patients who underwent intramural myomectomy. Design Retrospective study. Setting Department of Obstetrics & Gynecology, Center of Gynecological Endoscopy and Minimally Invasive surgery, 1st Faculty of Medicine, General University Hospital in Prague. Patients A total of 55 women who underwent surgical resection of uterine adenomyosis and 55 patients who underwent myomectomy for intramural uterine fibroid/s were included in this study. All study participants wished to retain and possibly improve their reproductive potential. Interventions Between 2004 and 2019, 110 women underwent laparoscopic or open uterus-sparing surgery for clinically significant uterine adenomyosis (group A) or fibroids (group B), respectively. Measurements and main results Two groups of women who underwent different fertility-saving procedures were compared. Although all women entering the study had declared their wish to conceive, only 28 patients in group A (group A1) and 24 women in group B (group B1) finally aimed toward pregnancy. The mean age and follow-up period was 35.0 years and 76.81 months, respectively, in group A and 34.8 years and 72.5 months, respectively, in group B. The pregnancy and delivery rates were 75.0% and 46.4%, respectively, in group A1 versus 96.0% and 70.8%, respectively, in group B1, with no significant differences between the two groups. The open surgical approach was significantly more frequently employed in group A (47.3% versus 16.4%; p Conclusions In this study, women who underwent surgery on the uterine muscularity, including myomectomy or adenomyomectomy, had comparable reproductive outcomes, with no significant differences. |
| Databáze: | OpenAIRE |
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