Cesarean myomectomy for solitary uterine fibroids: Is it a safe procedure?

Objectives: Myomectomy during cesarean is still controversial. Our aim is to assess the safety and feasibility of myomectomy during cesarean section for solitary uterine fibroids in terms of intraoperative and postoperative risks. Material and methods Data from 306 patients with leiomyoma undergoing elective cesarean operations were reviewed retrospectively. Eighty-two patients who underwent myomectomy during cesarean section were compared to 224 patients diagnosed with myoma who did not undergo myomectomy. The patients were reviewed for pre- and post-operative hemoglobin values, duration of operation, amount of intraoperative hemorrhage, need for blood transfusion, and duration of hospital stay. Results: The decrease in hemoglobin values after operation was not significantly different between the groups (1.48 +/- 0.7 vs. 1.31 +/- 0.68 g/dL; p = 0.063). Both the hospital stay and operation durations were significantly longer in the myomectomy group (57.9 +/- 19.7 vs. 50.54 +/- 20.77 hours, p = 0.006; 39.94 +/- 12.5 vs. 35.27 +/- 9.1 minutes, p = 0.001, respectively). The operation duration was significantly shorter in the group with myomas = 3 cm in size (35.41 +/- 9.33 vs. 45.58 +/- 16.57 vs. 47.05 +/- 10.61 minutes; p < 0.05). Conclusions: Cesarean myomectomy did not increase intrapartum or early postpartum morbidity. Thus, we suggest that myomectomy can be performed during cesarean section in selected patients to avoid repeat operations and additional cost.