Prevalence and Outcomes of Myomectomy in a Tertiary Hospital in Southern Nigeria

Abstract

Background: Uterine fibroids affect adversely various age groups especially the reproductive age. Abdominal myomectomy is the most common treatment in this environment. The aim of the study was to determine the prevalence of myomectomy, post-operative complications, duration of hospital stay and association between the patients’ characteristics, clinical presentation and estimated blood loss at the Rivers State University Teaching Hospital (RSUTH). Methods: A retrospective descriptive study on women who had abdominal myomectomy over a period of 5 years from 1st January, 2016 to 31st December, 2020 at RSUTH. A structured proforma was designed and used to extract data from gynaecology ward, operating theatre registers and the hospital medical records. Data was entered and analyzed using the statistical package for social sciences (SPSS) IBM version 25.0 (Armonk, NY). Continuous variables are expressed in means+ standard deviations and categorical variables are recorded in frequencies and percentages. Chi square test was used for association between patients’ characteristics, their clinical presentation and estimated blood loss with p value at <0.05.  Results: A total of 1682 gynaecological surgeries were done over the study period. Four hundred and six had abdominal myomectomy giving a prevalence of 24.1%. Of the 468 uterine fibroids surgeries done over the study period, 406 (86.7%) were abdominal myomectomies while 13.3% had abdominal hysterectomies.  Mean age was 36.63 + 5.09 years. Range of parity was Para 0–3. Most were married, aged 30-35 years, nulliparous and had tertiary level of education. Menorrhagia was the most common presenting symptom. Mean blood loss was 516.5+ 245.05mls. Majority lost <500mls of blood and did not have any post-operative complication. The average length of hospital stay was 5-7 days. There was no association between patients’ characteristics, their clinical presentation and estimated blood loss. Conclusion: Abdominal myomectomy remains the most common treatment for uterine fibroids in our environment. Routine checkups is encouraged to detect and possibly treat it early with other less invasive methods.