STATE AND CHARACTERISTICS OF REPRODUCTIVE FUNCTION IN PATIENTS AFTER CONSERVATIVE MYOMECTOMY
DOI:
https://doi.org/10.11603/24116-4944.2026.1.16122Keywords:
uterine leiomyoma, conservative myomectomy, reproductive function, uterine scar, laparoscopic interventions, childbirth with a uterine scar, myometrial restoration, uterine scar insufficiencyAbstract
The aim of the study – to analyze the state and characteristics of reproductive function in patients after conservative myomectomy.
Materials and Methods. The study was conducted at the Municipal Nonprofit Enterprise of the Sumy Regional Council “Regional Clinical Perinatal Center” during 2020–2025. A total of 120 women of reproductive age with uterine leiomyoma were examined. The mean age of the patients was (33.7±5.7) years. The examination program included clinical observation, laboratory and instrumental diagnostic methods, morphological examination of surgical specimens, and statistical analysis of the obtained results.
Results and Discussion. A retrospective analysis showed that the main indications for surgical treatment of leiomyoma were menstrual cycle disorders (41.7 %), pain syndrome (26.7 %), impaired generative (reproductive) function (23.3 %), iron-deficiency anemia (18.3 %), and dysuric disorders (2.5 %). Removal of more than three fibroid nodules was performed in 15.0 % of cases, with the number of nodules exceeding five in 8.3 % of patients. Opening of the uterine cavity during surgery occurred in 15.0 % of patients; however, only in 5.0 % of cases this was associated with submucosal localization of the nodule. Pregnancy after myomectomy occurred in 19.2 % of women, including 13.3 % of patients with a history of infertility. In 4.2 % of cases, pregnancy ended in spontaneous miscarriage at 8–12 weeks of gestation. Pregnancy resulted in childbirth in 15.0 % of women: by cesarean section in 9.2 % and via vaginal delivery in 5.8 %. Recurrence of leiomyoma after conservative myomectomy during five years of follow-up was diagnosed in 14.2 % of patients, most often 1–2 years after surgery. No association was found between the number or size of removed nodules and the risk of recurrence.
Conclusions. The obtained results indicate a favorable effect of conservative myomectomy on the restoration and normalization of reproductive function in women with uterine leiomyoma. Surgical intervention contributed to the elimination of the main clinical complaints in the vast majority of patients. At the same time, no significant impact of surgery on the overall level of gynecological morbidity was identified, and the recurrence rate remained relatively low.
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