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Obstet Gynecol. 2005 Apr;105(4):877-81.

Predictors of leiomyoma recurrence after myomectomy.

Author information

  • 1Saint Joseph's Hospital of Atlanta, Georgia 30342, USA. Mhanafi@aol.com

Abstract

OBJECTIVE:

The purpose of this study was to evaluate the factors associated with the recurrence of leiomyomata after myomectomy.

METHODS:

One hundred forty-five consecutive cases of myomectomy by laparotomy were studied retrospectively. Leiomyoma recurrence, diagnosed by transvaginal ultrasonography, was evaluated by life-table analysis and log-rank tests according to clinical characteristics of patients.

RESULTS:

The 5-year cumulative rates for leiomyoma recurrence and subsequent major surgery were 62% and 9%, respectively. At 5 years, the cumulative probability of recurrence was significantly lower in patients with a single leiomyoma removed (11%), compared with patients with multiple leiomyomata (74%) (P = .011); it was also lower in patients with intraoperative uterine size 10 menstrual weeks or less (46%), compared with more than 10 menstrual weeks (82%) (P = .032). However, there was a strong association of uterine size with the number of leiomyomata removed (P = .009). Childbirth after myomectomy was associated with a lower recurrence rate; the 5-year cumulative probability of recurrence was 26% in patients with subsequent parity, compared with 76% in those without subsequent parity (P = .010).

CONCLUSION:

Solitary myomectomy and smaller intraoperative uterine size are associated with lower rates of leiomyoma recurrence after myomectomy; the significance of uterine size may be affected by its correlation with the number of leiomyomata removed. Subsequent parity is associated with a lower probability of recurrence, but the cause and effect relationship between these two variables is unclear.

LEVEL OF EVIDENCE:

II-3.

PMID:
15802421
[PubMed - indexed for MEDLINE]
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