Pros and Cons of Myomectomy during Cesarean Section

Additional surgical interventions apart from emergencies during cesarean section are not recommended in the textbooks; thus, surgical procedures like myomectomy as an adjunct to cesarean section remains a hot topic of discussion. There are many publications supporting serosal myomectomy during cesarean section, but studies published so far are poor in quality of evidence. To clarify the efficacy and safety of cesarean myomectomy, large-scale randomized controlled studies and studies explaining the mid-term and long-term outcomes of the cesarean myomectomy are required. Traditionally, cesarean myomectomy is performed from the uterine serosa as in the usual abdominal myomectomy. Although the surgical technique is the same as intracapsular myomectomy, a novel cesarean myomectomy technique, endometrial myomectomy, introduced into the obstetrics practice for minimizing the risk of adhesion formation and diminishing the blood loss during surgery. Further, strong studies are needed to overcome the controversy on cesarean myomectomy.