Publication: Clinical predictors of successful vaginal myomectomy for prolapsed pedunculated uterine leiomyoma
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Date
2018-08-06
Authors
Aydın, SERDAR
Göksever, Çelik
MARASLI, MUSTAFA
BAKAR, RABİA ZEHRA
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Abstract
Objective: Uterine leiomyomas are the most common pelvic tumor in women. The calculated prevalence of prolapsed pedunculated
leiomyoma was 2.5% in patients who underwent surgery. Although vaginal removal is safe and effective, hysterectomy demand is questionable.
We aimed to analyze the association between patient characteristics, clinical features of prolapsed pedunculated submucosal leiomyoma, and
the probability of successful vaginal myomectomy.
Material and Methods: This study was conducted in 35 women who presented with prolapsed pedunculated uterine leiomyoma. Patients
were grouped according to the treatment procedure, either vaginal myomectomy or hysterectomy.
Results: Hysterectomy was performed in 14 patients and vaginal myomectomy was performed in 21 women. The mean ages and menopausal
status were similar. Parity was higher in the hysterectomy group (p=0.02). The preoperative hematocrit value of patients undergoing vaginal
myomectomy was significantly lower (p=0.04). There was no significant difference between the groups regarding the largest leiomyoma
diameter. However, the median calculated leiomyoma volume was lower in the vaginal myomectomy group (p=0.04). None of the variables
were independently associated with successful vaginal myomectomy on multivariable logistic regression analysis.
Conclusion: The feasibility and choice of vaginal myomectomy is associated with low parity, absence of coexisting leiomyoma, high volume of
leiomyoma estimated via ultrasound measurement, and severe anemia. (J Turk Ger Gynecol Assoc 2018; 19: 146-50)
Keywords: Leiomyoma, prolapsed pedunculated submucosal leiomyoma, vaginal myomectomy, hysterectomy
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Aydın S., Göksever Ç., MARASLI M., BAKAR R. Z. , -Clinical predictors of successful vaginal myomectomy for prolapsed pedunculated uterine leiomyoma-, Journal of the Turkish German Gynecological Association, cilt.19, ss.146-150, 2018