Surgical management of uterine fibroids in a tertiary hospital in south-west Nigeria

Abstract

Context: Symptomatic uterine fibroids are frequently encountered in gynecological practice in black populations. An evaluation of the surgical management is in order to audit practice, highlight complications, and facilitate care. Aims: This study aimed to evaluate morbidity following abdominal myomectomy and hysterectomy for symptomatic uterine fibroids. Settings and Design: A cross-sectional study retrospectively reviewing cases of symptomatic uterine fibroids that were managed surgically at a tertiary hospital in south-west Nigeria. Methods and Material: Surgeries performed over a five-year period were retrieved from the gynecological theatre of the hospital. The case notes were retrieved and information on socio-demographic, perioperative and postoperative characteristics was obtained. Statistical analysis used: Chi-square tests and Student's-t tests were performed to evaluate categorical and continuous variables, respectively. Significant P was set at < 0.05. Results: Of 214 eligible cases, 79 (36.9%) had hysterectomy and 135 (63.1%) had myomectomy. No other surgical treatment methods were employed. Age was the only significant socio-demographic feature; younger women were more likely to have myomectomy (P < 0.001). Mean blood loss and transfusion rates were comparable between the two groups. Complications included hemorrhage in 36.0%, wound infection in 4.7%, and postoperative fever in 1.9%. There were no conversions of myomectomy to hysterectomy and no mortalities. There was no significant difference in the prevalence of complications in either surgery group. Conclusions: Apart from hemorrhage, morbidities were few in this series. Gynecologists should ensure adequate preparations to control blood loss before and during fibroid surgery.