Rolli Riccardo, Favilli Alessandro, Acanfora Marta Maddalena, Scuderi Gaetano, Di Renzo Gian Carlo, Gerli Sandro
Department of Obstetrics and Gynecology, Ospedale Civile, Asiago, Italy.
J Obstet Gynaecol Res. 2012 Sep;38(9):1201-5. doi: 10.1111/j.1447-0756.2012.01852.x. Epub 2012 May 8.
The aim of this study was to establish the feasibility and safety of vaginal myomectomy via posterior colpotomy in a series of consecutive procedures performed by one surgeon.
We conducted a retrospective study in a tertiary care university hospital, involving 46 patients with symptomatic myomas and uteruses smaller than 16 gestational weeks and with no signs of pelvic disease. After a presurgical study, the patients underwent vaginal myomectomy. Characteristics of patients, position and size of myomas, operative data, intraoperative and postoperative complications, and length of hospital stay were recorded.
Forty-four women underwent vaginal myomectomy and conversion to laparotomy was required in two cases (4.3%). Two patients suffered from infertility and one of these achieved pregnancy after the procedure. The median size of myomas was 50 mm (range 16-81). In two cases a culdoscopy was performed with a flexible fiberoptic gastroscope to better evaluate size and localization of myomas. Thirty-two patients underwent vaginal myomectomy under general anesthesia and 12 under locoregional anesthesia. The median vaginal operating time was 70 min (range 30-120). The estimated hemoglobin loss was 0.70 g/dL (range 0.40-3.35 g/dL). No severe intraoperative complications occurred. The median duration of hospital stay was 1 day (range 1-6).
Vaginal myomectomy is a safe and feasible surgical procedure if performed by a well-trained, experienced surgeon.
