Short-Term Outcome of Abdominal Myomectomy at Charlotte Maxeke Johannesburg Academic Hospital

Abstract

Objectives: To describe the preoperative findings in patients who underwent abdominal myomectomy, determine the indications for abdominal myomectomy based on presenting symptoms, assess intraoperative and postoperative findings and outcomes before discharge from the hospital in this cohort of patients. Methods: This is a descriptive retrospective study. We identified and reviewed the clinical records of patients who had abdominal myomectomy at the study site from January 1, 2016, to December 31, 2019. Descriptive and inferential statistics, including Pearson’s Chi-square test and simple linear regression, were used to describe the study population and to determine the relationships between patients’ profiles and the outcome of abdominal myomectomy. Results: Out of 180 patients who underwent an abdominal myomectomy, only 120 (66.7%) had complete records available for analysis. The mean age of the patients was 35.8 years (SD = 4.9). Most patients were nulliparous (87, 72.5%) and desired future fertility (116, 96.7%). The primary reason for myomectomy was vaginal bleeding (86, 71.7%). An average of 7.53 fibroids (SD = 6.34) were removed per patient, and the mean uterine size was equivalent to 19 weeks of gestation (SD = 5.6). Apart from a longer operation time (mean = 122.1 minutes, SD = 49.9) and increased blood loss (mean = 878.3 mL, SD = 600.8), no other adverse 2 outcomes like death or conversion to hysterectomy were observed. A significant association was observed between uterine size and the number of fibroids, with both longer duration of operation and greater blood loss. Conclusions: Abdominal myomectomy is a safe surgical option for women of reproductive age who wish to preserve their uteruses. Despite an increased operative time and blood loss associated with a higher number of fibroids or larger uterine size, no major complications— including mortality or conversion to hysterectomy—were observed. These findings support the continued use of abdominal myomectomy in appropriately selected patients seeking a uterine preservation surgical procedure. Ethics: Ethics clearance was obtained from the Human Research Ethics Committee of the University of the Witwatersrand (approval number: M220340), and the study was registered in the National Health Research Database (NHRD number: GP_202205_058).