Transvaginal myomectomy with screw traction by colpotomy.

INTRODUCTION

The aim of this study is to evaluate the clinical effectiveness and safety of the enucleation of uterine leiomyomas by traction method via colpotomy.

METHODS

Ten women with menorrhagia, pelvic pain, or secondary infertility associated with single uterine myomas underwent transvaginal myomectomy with screw traction by colpotomy. The feasibility of the procedure, operative complications, postoperative recovery, pregnancies, and relief of symptoms were the main outcome measures.

RESULTS

Traction myomectomy was completed vaginally in all patients. The mean operating time was 71 min and average blood loss 385 ml. The mean size of a single myoma was 6.7 cm (range 5.6-8.0 cm) and weight 153 g. One patient developed a transient hematoma. All women reported relief of their symptoms after a mean follow-up of 24 months. Three patients had a term delivery postoperatively.

CONCLUSIONS

Traction myomectomy by colpotomy is a feasible approach for selected patients wishing to preserve their ability to conceive. A single well-lined myoma of 5-8 cm diameter and possible to reach via colpotomy is a suitable subject for the procedure, which proved a viable surgical approach.