Vaginal myomectomy using posterior colpotomy: feasibility in normal practice.
BACKGROUND
Myomectomy is classically performed via laparotomy. Endoscopic surgery is limited for some indications. Vaginal myomectomy is a surgical procedure that has recently been evaluated. The aim of this study was to evaluate the feasibility, reproducibility and complication rate of vaginal myomectomy via posterior colpotomy.


METHODS
A retrospective study was performed from November 1998 to February 2001 in three departments of gynaecology.


RESULTS
Forty-five patients were involved, 17 (37.8%) of whom underwent laparoscopy before vaginal myomectomy for evaluation or treatment of a second pelvic disorder. Myomectomy was performed vaginally in 40 (89%) of the 45 patients. Peroperative laparotomy was required in five patients (11%), either because vaginal myomectomy proved impossible (four cases) or because of rectal injury (one case). One patient needed supplementary laparotomy on day 8 for the treatment of a pelvic abscess.


CONCLUSIONS
Posterior vaginal myomectomy seems to be a feasible and reproducible surgical procedure. The success rate of vaginal myomectomy in this study was over 80%. Further randomised studies are needed to compare this procedure with laparotomy and laparoscopy.
Agostini
Aubert
A
Department of Obstetrics & Gynaecology B, La Conception Hospital, 147 Boulevard Baille, 13385 Marseille Cedex 05, France. aagostini@mail.ap-hm.fr
Deval
Bruno
B
Birsan
Anka
A
Ronda
Isabelle
I
Bretelle
Florence
F
Roger
Valérie
V
Cravello
Ludovic
L
Madelenat
Patrick
P
Blanc
Bernard
B
D000328:Adult; D020884:Colpotomy / Q000009:adverse effects* / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005602:France; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D009215:Myometrium / Q000601:surgery*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014591:Uterine Diseases / Q000601:surgery*; D014621:Vagina / Q000601:surgery*