Kundu S, et al. - Patients undergoing surgery for symptomatic myomas by laparoscopy or laparotomy were retrospectively analyzed, with focus on morbidity, fertility and pregnancy outcomes. Regardless of the surgical approach adopted, high pregnancy rates (up to 70%) and birth rates (up to 86%) after myomectomy were reported. Furthermore, a statistically significant negative correlation was observed in relation to the association between the size of the largest myoma extracted and the pregnancy rate. Ensuring sound preoperative selection of the surgical approach deemed necessary in order to achieve the most optimal results, especially for those patients who wished to bear children.

• In this retrospective design study, researchers retrospectively analysed data of 265 patients undergoing surgery for symptomatic myomas by laparoscopy or laparotomy, performed in the gynaecological department of Hannover Medical School, Hannover, Germany, between 2009 and 2013.

• Findings demonstrated high pregnancy rates (up to 70%) and birth rates (up to 86%) after myomectomy, regardless of the surgical approach adopted.
• Researchers noted a trend that ≥ 3 myomas and those that were ≥ 6 cm in size were almost always removed by laparotomy in their clinic.
• Removal of up to 42 myomas was possible without having to perform a hysterectomy.
• Data also showed that a statistically significant negative correlation was observed in relation to the association between the size of the largest myoma extracted and the pregnancy rate (p=0.02).
• For patients who wished to bear children (p=0.010), researchers observed a statistically significant correlation between the number of removed myomas and the pregnancy rate.
• Additionally, they reported elevated complication rates (of up to 50%) for more than three extracted myomas with a statistically significance (p=0.0471).