Feasibility and safety of vaginal myomectomy: analysis of 90 cases

Background Vaginal myomectomy was firstly reported in 1994, however, it is a relatively new technique in China. The feasibility and safety of the procedure is still controversial in this country. The aim of this study was to analyze the outcomes of vaginal myomectomy in 90 patients and to investigate the feasibility and safety of the surgery. Methods From June 2001 to June 2004, 90 patients with uterine leiomyoma were treated with vaginal myomectomy in our hospital (vaginal group). The indications, operative performance, postoperative complications, and recovery of the patients were analyzed and compared with those of 93 patients with uterine leiomyoma treated by laparotomic myomectomy from January 2000 to January 2001 (laparotomy group). The Student's t test was used to compare the continuous variables between the two groups, and the chi-square test was used to compare the categorical variables. The vaginal and laparotomy groups were followed up for 10-34 months (median, 21) and 15-24 months (median, 30), respectively. Results Vaginal myomectomy was performed successfully in 87 of the 90 patients (96.7%). In the other 3 patients, the procedure failed and laparotomy was carried out. In both groups, the uterus was enlarged to 8-16 weeks gestational size (median, 10 gestational weeks). The number of resected tumors was 1 - 12 (median, 2) in the vaginal group and 1 - 15 (median, 4) in the laparotomy group, respectively (P > 0.05). The mean operating time, intraoperative blood loss, and postoperative hospital stay were (52 +/- 21) minutes, (230 +/- 44) ml, and (7.0 +/- 1.2) days in the vaginal group, and (65 +/- 32) minutes, (200 +/- 56) ml, and (7.0 +/- 1.5) days in the laparotomy group (P > 0.05). The mean top postoperative temperature was (38.4 +/- 1.1)degrees C and (37.8 +/- 0.6)degrees C in the two groups respectively (P < 0.05). Both groups had one recurrent case during the follow-up (P > 0.05). Conclusions Vaginal myomectomy is feasible and safe in treating uterine leiomyoma. To some extent, it is superior to laparotomic myomectomy by avoiding severe trauma during the surgery.