Assessment of reproductive potential in patients after myomectomy

Abstract

The aim of the study is to assess the restoration of anatomical and functional integrity of the uterus and identify changes in hormonal profile in women after laparoscopic and abdominal myomectomy.

Material and methods. 58 patients aged 36,2 ± 5,9 years old with uterine myoma underwent myomectomy: 31 patients underwent laparoscopic myomectomy and 27 patients underwent abdominal myomectomy.

The selection of surgical approach didn´t depend on the size, the number and localization of uterine myomas and the patient´s concomitant pathology.

The hormonal profile of the patients including AMH level was assessed befor myomectomy and in the 6 months after the operation. Postoperative assessment was performed on day 5^th–8^th after surgery and in 1 and 6 months after myomectomy.

Results. No significant differences were found in the processes of reparation of the uterus and in hormonal profile of the patients after laparoscopic or abdominal myomectomy. The time required for the patients´ reabilitation and for the restoration of the ovarian function and uterine morphological structure was similar in both groups.

Conclusion. The hormonal profile of the patients and the anatomical and functional restoration of myometrium after myomectomy doesn´t depend on the surgical approach if myomectomy is performed by an experienced surgeon after the correct assessment of the clinical situation.

Keywords

reproductive potential / uterine scar after myomectomy / myomectomy

References

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[23] REFERENCES

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[25] Dubussion JB, Leluru F, Foulot H. Laparoscopic myomectomy: where do we stand? Gynecol. Endosc. 1995;4:83‒86.

[26] Zepiridis LI, Grimbizis GF, Tarlatzis BC, et al. Infertility and uterine fibroids. Best Pract Res Clin Obstet Gynaecol. 2016;34:66‒73. doi: 10.1016/j.bpobgyn.2015.12.001

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[28] Burlakova O.A. Vosstanovlenie reproduktivnoi funktsii u bol’nykh miomoi matki v zavisimosti ot sposoba miomektomii i metodov reabilitatsii [dissertation]. Perm’; 2013. Available from: https://www.dissercat.com/content/vosstanovlenie-reproduktivnoi-funktsii-u-bolnykh-miomoi-matki-v-zavisimosti-ot-sposoba-miome. (In Russ).

[29] Popov AA, Fedorov AA, Loginova EA, et al. Uterine fibroids: in favor of surgical treatment for infertility. Meditsinskiy alfavit. 2017;(23):46‒49. (In Russ).

[30] Bansal B. Minimally invasive surgical techniques vs open myomectomy for treatment of uterine fibroids. World J Lapar Surg. 2016;9(3):126‒129.

[31] Dobrokhotova YuE, Nasyrova NI, Gavrilov MV. Modern suture materials used in myomectomy. Akusherstvo i ginekologiya. 2015;(8):53‒58. (In Russ).

[32] Dolinskiy AK, Tolibova GKh, Tral’ TG, Bezhenar’ VF. Molecular assessment of myogenesis and the state of the uterine scar after myomectomy with various surgical approaches. Molekulyarnaya meditsina. 2014;(1):22‒27. (In Russ).

[33] Conforti A, Krishnamurthy GB, Dragamestianos C, et al. Intrauterina adhesions after open myomectomy: an audit. Eur J Obstet Gynaecol Reprod Biol. 2014;179:42‒45.

[34] Lee D, Kim SK, Kim K, et al. Advantages of single-port laparoscopic myomectomy compared with conventional laparoscopic myomectomy: a randomized controlled study. J Minim Invasive Gynecol. 2018;25(1):25‒29. doi: https://doi.org/10.1016/j.jmig.2017.08.651

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