Morbidity of Abdominal Myomectomy when Compared with Abdominal Hysterectomy in the Management of Uterine Fibroids

Original article


Ramadan El Gantri, Lubna Aya, Mustafa Gawass.

Department of Obstetric and Gynaecology, Faculty of Medicine, Al Fateh University Tripoli, Libya.

JMJ 2010, Vol.10, No.2:123-129


Objective: To compare between abdominal hysterectomy and myomectomy in terms of postoperative complications. Setting: The obstetrics and gynaecological department at Tripoli Medical Centre (TMC). Study design: A prospective observational study over a period of one year (1stjanuary 2007 to 1stjanuary 2008). The study involved all patients undergoing surgery for uterine fibroids in our unit which included 69 patients. The patients who were diagnosed preoperatively as having uterine haemorrhage due to fibroids and then confirmed by histopathology following surgery were included. The decision on the type of surgery was taken according to the patient’s age, parity, marital status and preference, and was independent of the research. Data was collected from the patient’s chart. Operative complications considered in the study included intra-operative bleeding, surgical time, febrile morbidity, and the duration of hospital stay. Intra-operative haemorrhage was estimated from the drop in the haemoglobin concentration postoperatively, and the need for blood transfusion, the patient’s haemoglobin concentration was checked the day before surgery and 3 days after. Febrile morbidity was defined as temperature equal to or more than 38° C after twenty four hours postoperatively. We considered patients who had had abdominal myomectomy of a single fibroid as a separate group because it is a relatively simpler operation than multiple myomectomy. Results: We included 69 patients in our study. 25 patients (36.2%) had an abdominal hysterectomy and 44 patients (63.8%) had myomectomy. The mean age was 40 years of age (±SD 7.52) whereas the mean parity was 2.06 (±SD 2.86). The main presentation was menorrhagia (62.3%) followed by an abdominal mass which was present in 14.5% of cases. There was a less significant drop in haemoglobin concentration postoperatively in patients with hysterectomy when compared with patients who underwent myomectomy. Finally regarding hospital stay, there was no significant difference in all patients. Conclusion: We conclude that abdominal myomectomy especially for a single fibroid is a relatively a safe operation and a reasonable alternative to hysterectomy particularly in our community that favors preservation of the uterus.

Keywords: Myomas, Incidence, Myomectomy, Hysterectomy, Complications