title: The incidence of repeat uterine surgery following myomectomy.
abstract: OBJECTIVE
  To determine the incidence of subsequent leiomyoma surgery following myomectomy in a population-based cohort.
  
  
  METHODS
  All women, ages 20-75 years, enrolled in a large HMO in Washington State, identified by CPT and ICD-9 codes as having a myomectomy between January 1, 1993, and December 31, 2002, were eligible for the study. The follow-up period was 0.1-11 years. Automated enrollment and inpatient, outpatient, pathology, and procedure data were linked. Age-adjusted hazard ratios (HR) and 95% confidence intervals (CI) using Cox proportional hazard models, age-specific Kaplan Meier estimates of cumulative risk, and incidence of uterine surgery after myomectomy were calculated.
  
  
  RESULTS
  Among 628 eligible women, 127 (21.8%) had a second surgery, 95 (74.8%) of which were hysterectomies. The cumulative incidence of a second surgery was 23.5% at 5 years and 30% at 7 years. During 2766.5 woman-years of follow-up, the annual incidence of a subsequent myoma surgery was 4.6%. Compared with women aged 40-44, women >or=50 had a 50% decreased risk for subsequent surgery (HR = 0.5, 95% CI 0.3-0.9).
  
  
  CONCLUSIONS
  The incidence of subsequent surgery for leiomyomas following myomectomy is high, almost 5% per year.
authors.affiliation: Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA. reeds@u.washington.edu
authors.forename: Susan D
authors.initials: SD
authors.lastname: Reed
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Newton
authors.forename: Laura B
authors.initials: LB
authors.lastname: Thompson
authors.forename: Brenna A
authors.initials: BA
authors.lastname: McCrummen
authors.forename: Audrey K
authors.initials: AK
authors.lastname: Warolin
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000706:statistics & numerical data*; D007889:Leiomyoma / Q000453:epidemiology / Q000601:surgery*; D008875:Middle Aged; D009215:Myometrium / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000601:surgery*; D012086:Reoperation; D012307:Risk Factors; D014594:Uterine Neoplasms / Q000453:epidemiology / Q000601:surgery*; D014861:Washington / Q000453:epidemiology; D016387:Women's Health