TY - JOUR
T1 - The Effect of a Myomectomy on Myoma-related Symptoms and Quality of Life
T2 - A Retrospective Cohort Study
AU - Don, Emma E.
AU - Mijatovic, Velja
AU - van Eekelen, Rik
AU - Hehenkamp, Wouter J. K.
AU - Huirne, Judith A. F.
N1 - Funding Information: The authors thank Claire H. Laeven and Guus Vissers for their help in contacting patients and data-entry work in Castor during their scientific internships. Publisher Copyright: © 2023 AAGL
PY - 2023/11
Y1 - 2023/11
N2 - Study Objective: Although it is assumed that myomectomy improves uterine myoma-related symptoms such as pelvic pain and heavy menstrual bleeding (HMB), validated measures are rarely reported. This study aimed to verify the effect of myomectomy on myoma-related symptoms. Design: A retrospective cohort study. Setting: A university-affiliated hospital. Patients: Our study included 241 patients with a myoma diagnosis and received a myomectomy between 2004 and 2018. Data were collected from the patient medical file and patients responded in 1 questionnaire. Interventions: Transcervical resection of myoma (TCRM) and laparoscopic or abdominal myomectomy (LAM). Measurements and Main Results: One year after TCRM, a significant number of women experienced symptom improvement for pelvic pain (79% [19/24, p = .01]) and HMB (89% [46/52, p <.001]). For other myoma-related symptoms, abdominal pressure (43%, 10/23), sexual complaints (67%, 2/3), infertility (56%, 10/18), and other complaints (83%, 5/6), improvements were not statistically significant. One year after LAM, a significant number of women experienced symptom improvement for pelvic pain (80%, 74/93), HMB (83%, 94/113), abdominal pressure (85%, 79/93), sexual complaints (77%, 36/47), and other complaints (91%, 40/44). One year after myomectomy, 47% (30/64) (TCRM) and 44% of women (78/177) (LAM) described no myoma-related symptoms. Most women (82% [172/217]) were satisfied with the postoperative result after 1 year and 53% (114/217) would have liked to receive the myomectomy earlier in life. Average quality of life (measured on a 10-point Likert scale) increased from 6.3 at baseline to 8.0 at 1 year after TCRM and from 6.2 to 8.0 1 year after LAM, resulting in a difference of 1.7 points (p <.001; 95% confidence interval, 1.1–2.3) and 1.9 points (p <.001; 95% confidence interval, 1.4–2.3), respectively. Conclusion: One year after myomectomy, most women have benefited from myomectomy, concluded by a significant number of women who experienced myoma-related symptom improvement, positive patient satisfaction, and a significant improvement in reported quality of life. Validation of results after conventional treatment such as myomectomy is essential in counseling patients for surgical treatment in today's evidence based practice. In addition, it is necessary to make an adequate comparison with new treatment options for myomas. To provide this, further research should preferably be conducted prospectively or by randomization.
AB - Study Objective: Although it is assumed that myomectomy improves uterine myoma-related symptoms such as pelvic pain and heavy menstrual bleeding (HMB), validated measures are rarely reported. This study aimed to verify the effect of myomectomy on myoma-related symptoms. Design: A retrospective cohort study. Setting: A university-affiliated hospital. Patients: Our study included 241 patients with a myoma diagnosis and received a myomectomy between 2004 and 2018. Data were collected from the patient medical file and patients responded in 1 questionnaire. Interventions: Transcervical resection of myoma (TCRM) and laparoscopic or abdominal myomectomy (LAM). Measurements and Main Results: One year after TCRM, a significant number of women experienced symptom improvement for pelvic pain (79% [19/24, p = .01]) and HMB (89% [46/52, p <.001]). For other myoma-related symptoms, abdominal pressure (43%, 10/23), sexual complaints (67%, 2/3), infertility (56%, 10/18), and other complaints (83%, 5/6), improvements were not statistically significant. One year after LAM, a significant number of women experienced symptom improvement for pelvic pain (80%, 74/93), HMB (83%, 94/113), abdominal pressure (85%, 79/93), sexual complaints (77%, 36/47), and other complaints (91%, 40/44). One year after myomectomy, 47% (30/64) (TCRM) and 44% of women (78/177) (LAM) described no myoma-related symptoms. Most women (82% [172/217]) were satisfied with the postoperative result after 1 year and 53% (114/217) would have liked to receive the myomectomy earlier in life. Average quality of life (measured on a 10-point Likert scale) increased from 6.3 at baseline to 8.0 at 1 year after TCRM and from 6.2 to 8.0 1 year after LAM, resulting in a difference of 1.7 points (p <.001; 95% confidence interval, 1.1–2.3) and 1.9 points (p <.001; 95% confidence interval, 1.4–2.3), respectively. Conclusion: One year after myomectomy, most women have benefited from myomectomy, concluded by a significant number of women who experienced myoma-related symptom improvement, positive patient satisfaction, and a significant improvement in reported quality of life. Validation of results after conventional treatment such as myomectomy is essential in counseling patients for surgical treatment in today's evidence based practice. In addition, it is necessary to make an adequate comparison with new treatment options for myomas. To provide this, further research should preferably be conducted prospectively or by randomization.
KW - Infertility
KW - Leiomyoma
KW - Menorrhagia
KW - Uterine myomectomy
UR - http://www.scopus.com/inward/record.url?scp=85167833926&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jmig.2023.07.001
DO - https://doi.org/10.1016/j.jmig.2023.07.001
M3 - Article
C2 - 37453499
SN - 1553-4650
VL - 30
SP - 897
EP - 904
JO - Journal of Minimally Invasive Gynecology
JF - Journal of Minimally Invasive Gynecology
IS - 11
ER -