Author/Authors :
Asgari ، Zahra Department of Gynecology - School of Medicine, Arash Hospital - Tehran University of Medical Sciences , Pourhoseini ، Azam Department of Obstetrics and Gynecology - School of Medicine - Mashhad University of Medical Sciences , Hosseini ، Reihaneh Department of Gynecology - School of Medicine, Arash Hospital - Tehran University of Medical Sciences , Ghavami ، Behnaz Department of Gynecology - School of Medicine, Arash Hospital - Tehran University of Medical Sciences , Meibodi ، Bahareh Department of Gynecology - School of Medicine, Arash Hospital - Tehran University of Medical Sciences , Akbari ، Ali Department of Psychiatry - Faculty of Medicine - Mashhad University of Medical Sciences
Abstract :
Background: Although laparoscopic myomectomy is an effective procedure for the treatment of uterine myoma, there is no clear consensus regarding its rate of recurrence and associated risk factors.Objectives: This study aimed to investigate the recurrence rate of myoma and its risk factors after laparoscopic myomectomy. Methods: In a historical cohort study, 172 patients who underwent laparoscopic myomectomy and had a minimum follow-up of 2 years were included. Myoma recurrence was checked semiannually by ultrasound imaging. The demographic, clinical, surgical, sonographic, and laboratory indices of the patients were compared between the recurrent and nonrecurrent groups, both in logistic regression models. Results: The mean age of the patients was 35 ± 5.7 years (range: 18 - 47 years). Their mean follow-up time was 26.3 ± 4.2 months (range: 24 - 28). The lesion recurred in 25 (14.5%) out of 172 patients. In the univariate analysis, higher age (OR:1.111, P = 0.015), higher body mass index (OR: 1.124, P = 0.024), gonadotropin-releasing hormone (GnRH) therapy (OR = 3.83, P = 0.027), and more than 1 myoma (OR: 2.60, P = 0.032) were associated with myoma recurrence. In the multiple analysis, a higher body mass index (OR: 1.222, P = 0.003) was a significant risk factor for myoma recurrence. Conclusions: Laparoscopic myomectomy is an effective procedure for the treatment of uterine myoma and can be used as a uterus-preserving surgical alternative in patients of reproductive age. A more radical surgical procedure might be used for patients with multiple risk factors, as revealed in the present study.
Keywords :
Myoma , Fibroid , Laparoscopic Myomectomy , Recurrence , Risk Factor