Anterior and posterior vaginal myomectomy: a new surgical technique.
OBJECTIVE
To evaluate the feasibility and safety of vaginal anterior and posterior myomectomy (A surgical technique is described.).


METHODS
Longitudinal prospective study.


METHODS
A gynecology department of a university teaching hospital.


METHODS
Women with surgical indication for myomectomy for pelvic pain, menorrhagia, symptoms of pressure, or subfertility caused by uterine myomas.


METHODS
From December 1998 to April 2005, all women with uterine myomas selected for surgical treatment were enrolled in a prospective study and underwent vaginal myomectomy.


METHODS
Feasibility of vaginal myomectomy, surgical data and morbidity, and relief of symptoms.


RESULTS
From 1998 to 2004, 54 patients underwent vaginal myomectomy. There were no cases of laparotomic conversion and hysterectomy. The average operation time was 80 minutes (range, 30 to 170 min). Average blood loss was 80 mL (range, 20 to 350 mL). No complications occurred. The average postoperative stay was 2 days (range, 1 to 3 days). Symptoms resolved in all 54 patients (100%) at 6 months follow-up, and 6 patients had a pregnancy.


CONCLUSIONS
Vaginal myomectomy, in well-selected cases, is feasible and well tolerated. Thanks to the "morcellation" technique, vaginal myomectomy can be useful even in case of large, numerous, and intramural fibroids and allows optimal uterine wall reconstruction with minimal tissue trauma. The procedure is also low time-consuming.
Carminati
Roberto
R
Department of Obstetrics/Gynaecology, Legnano Civil Hospital, Legnano, Italy. rcarm22@libero.it
Ragusa
Antonio
A
Giannice
Raffaella
R
Pantano
Francesco
F
D000328:Adult; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007889:Leiomyoma / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D014594:Uterine Neoplasms / Q000601:surgery*; D014621:Vagina