The effect of size and quality of uterine fibroids on outcome of cesarean myomectomy

WANG Dong-xue; WAN Qing-yu; WANG Bing-bing; XU Jing; JIN Jia-xi; SUN Jing-li

doi:10.16048/j.issn.2095-5561.2025.04.03

Abstract：Objective To explore the influence of the size and quality of uterine fibroids on the outcome of cesarean myomectomy(CM).Methods A total of 387 patients with uterine fibroids who underwent cesarean section were selected from the Northern Theater Command General Hospital between January 2012 and December 2022,aged(32.5±3.6)years old,ranging from 29 to 36 years old.Patients were divided into two groups based on their surgical methods:the CM group(n=162)and the cesarean section group(n=225).The CM group underwent combined cesarean section and myomectomy,while the cesarean section group underwent only a cesarean section.Clinical data,fibroid conditions,and surgical outcomes were compared between the CM group and the cesarean section group.The study also compared patients with the longest fibroid diameter reaching 5 cm(small myoma group),5 cm but not 10 cm(medium myoma group),or reached 10 cm(large myoma group),as well as those with fibroid masses less than 250 g(low quality group),250 g but not 500 g(medium quality group),or reached 500 g(high quality group),focusing on the surgical outcomes of the CM group.Results The proportion of nulliparous women,those with a history of abdominal surgery,and those with multiple fibroids in the CM group was higher than that in the cesarean section group.The longest diameter of fibroids in the CM group was also greater than that in the cesarean section group,with statistically significant differences(P＜0.05).There were no statistically significant differences in the incidence of pregnancy complications or postoperative complications between patients in the CM group and the cesarean section group(P＞0.05).Patients in the CM group had longer surgical times,estimated intraoperative blood loss,hospital stays,and transfusion rates compared to those in the cesarean section group,with statistically significant differences(P＜0.05).Comparing patients with small myoma group,medium myoma group,and large myoma group,there were statistically significant differences in the quality of removed fibroids,postoperative hemoglobin levels,surgical time,estimated intraoperative blood loss,hospital stay,transfusion status,and postoperative complication rates(P＜0.05).Comparing patients with low quality group,medium quality group,and high quality group,there were statistically significant differences in postoperative hemoglobin levels,estimated intraoperative blood loss,hospital stay,transfusion status,and postoperative complication rates(P＜0.05).Conclusion Cesarean section and myomectomy are safe and effective without increasing postoperative risk.