Outcomes of Abdominal Myomectomy in Rivers State University Teaching Hospital, Port Harcourt: A 5-Year Retrospective Study

Abstract

Background: Abdominal myomectomy is a common surgical option for the treatment of symptomatic uterine fibroids in women who wish to preserve their uterus. This study highlights the outcomes of abdominal myomectomies done in the Rivers State University Teaching Hospital (RSUTH). Methods: This was a retrospective cross-sectional study of all abdominal myomectomies done in this RSUTH between January 2017 to December 2021. Records from the theatre register, anaesthetic charts, patients' case notes and gynaecological ward were reviewed and the data obtained were analyzed using SPSS version 20. Results: A total of 540 women had surgery for uterine fibroids. Of these 512 (94.8%) had an abdominal myomectomy while 28 (5.2%) had a hysterectomy. A total of 315 (61.5%) fibroid cases had myomectomy due to infertility/ recurrent miscarriages, 129 (25.2%) for menorrhagia, 52 (10.2%) for huge abdominal/pelvic mass, and 16 (3.1%) for pressure symptoms. A total of 212 (41.4%) had satisfactory outcomes while 300 (58.6%) had complications. The majority (78%) of the perioperative complications were wound sepsis/dehiscence 127 (42.3%) and anaemia 108(36.0%). Other less common complications were fever, massive intraoperative haemorrhage (>1.5L), intestinal obstruction (paralytic ileus), iatrogenic bowel injury and anaesthetic complications. No death was recorded. Conclusion: Abdominal myomectomy is one of the most common treatments for symptomatic uterine fibroids. It generally has a favourable outcome, though significant perioperative complications can occur. Hence appropriate precautions should be taken to minimise these complications.