Myomectomy versus total abdominal hysterectomy in women with uterine fibroid

Abstract

Leiomyomas are benign tumors of the uterus with obscure etiology. These neoplasms are mostly seen in women during their reproductive age and are seen in 80% of them throughout their lifetime. By far, the uterine fibroid is the most frequent reason for surgery in young women. Myomectomy can be carried out via “hysteroscopy, laparoscopy, or classically as an abdominal procedure”. This study was aimed to find out what characteristics can predict the type of operation in women with uterine fibroid. The present cross-section study was included 56 women with uterine fibroid with a mean age of 40.54 ± 9 years. Forty women (71.4%) were married and the rest 16 women (28.6%) were unmarried. Myomectomy was carried out for 33 women (58.9%) and total abdominal hysterectomy was the operation of choice in 23 women (41.1%). Clinical presentation, the age of women, blood group and type of operation were the main variables included in the current study. The results of this study revealed that age was a strong predictor of the type of operation (P<0.001). The best age cutoff value was >40 years that made the best sensitivity and specificity combination, 91.30 % and 81.82 % respectively. In addition, marital status was a significant determinant of the type of operation. The Odds ratio of married women to undergo TAH was 7.74 (95% Confidence interval of 1.74-38.56); in other words, married women are at risk of undergoing THA approximately seven times those women who are unmarried. Women with blood group O+ were more associated with TAH than other groups followed by blood group B+, A+, AB+, and B-. Women age and state of marriage are by far the most reliable predictors for the type of surgical procedure done for women with uterine fibroid.