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Is myomectomy in women aged 45 years and older an effective option?

Eur J Obstet Gynecol Reprod Biol. 2014 Jun;177:57-60. doi: 10.1016/j.ejogrb.2014.04.006. Epub 2014 Apr 18.

Kim da H1, Kim ML2, Song T1, Kim MK1, Yoon BS1, Seong SJ1.
1Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, 566, Nonhyeon-ro, Gangnam-gu, Seoul 135-081, Republic of Korea.2Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, 566, Nonhyeon-ro, Gangnam-gu, Seoul 135-081, Republic of Korea. Electronic address: mila76@naver.com.
Eur J Obstet Gynecol Reprod Biol
ABSTRACT
OBJECTIVES: The aim of this study was to evaluate the recurrence and reoperation rate after myomectomy in women aged 45 years and older, who want to preserve their uterus.STUDY DESIGN: We performed a retrospective review of women aged =45 years that underwent myomectomy between January 2000 and December 2010. The inclusion criteria were premenopausal status, myomectomy through abdominal or laparoscopic surgery, and at least 12 months interval from surgery. The clinical outcomes, including symptomatic change, recurrence of myoma on transvaginal ultrasonography (TVS), and reoperation data were collected and analyzed.RESULTS: A total 92 patients were included in this study. The median age of the patient was 47 years (range 45-53 years), and the median follow-up duration was 30.5 months (range 12-95 months). On follow-up TVS, the recurrence of myoma was detected in 20 of 82 (24.4%) patients. Ten (10.9%) patients were not subjected to follow-up TVS. However, during their pelvic examination, the uterus was normal size, and all the 10 patients experienced symptomatic improvement and none of them needed additional surgical management. Using the Kaplan-Meier method, the cumulative recurrence rate at 36 months after myomectomy was calculated as 17.1%. Three patients underwent hysterectomy during the follow-up periods, and only one underwent hysterectomy due to myoma. The overall reoperation rate after myomectomy in this age group was 3.3%, and the reoperation for myoma rate was only 1.1%.CONCLUSION: Considering the natural regression of myoma after menopause, myomectomy might be an effective option for women aged 45 years and older, who want to preserve their uterus.Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Full Text Source: Elsevier Science
PMID:24768231 | http://www.ncbi.nlm.nih.gov/pubmed/24768231

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