title: The benefit of myomectomy in women aged 40 years and above: Experience in an urban teaching hospital in Nigeria.
abstract: BACKGROUND
  Abdominal myomectomy remains the mainstay of surgical management of uterine fibroids in our environment. However, its benefit in women aged 40 years and above remains debatable.
  
  
  METHODS
  An 11-year prospective study was conducted involving 98 women, aged 40 years and above, who had abdominal myomectomy for the treatment of uterine fibroid at the University of Maiduguri Teaching Hospital, Maiduguri. They were followed up regularly for 1-6 years to detect conception, resolution of symptoms and obstetrics performance. Data were analyzed using SPSS version 13.
  
  
  RESULTS
  The mean age of the patients was 42.6±2.9 years and 77 (78.6%) of them were nulliparous. Lower abdominal swelling was the commonest clinical presentation and the mean uterine size was 18.6±8.5 weeks. Infertility with uterine fibroids was the indication for myomectomy in majority of the cases [48 (48.9%)], while pregnancy complications accounted for 11.2% (11) of the cases Fertility restoration was 10.4% among the infertile patients. There was complete resolution of symptoms in 35.9% of those who required symptomatic relief, and term pregnancies were recorded in 72.7% of patients with pregnancy complications.
  
  
  CONCLUSIONS
  Myomectomy is the recommended treatment of uterine fibroids in women aged 40 years and above with infertility and who wish to become pregnant. If there is no need for further fertility preservation, hysterectomy should be offered.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria.
authors.forename: Jesse Y
authors.initials: JY
authors.lastname: Obed
authors.forename: Babagana
authors.initials: B
authors.lastname: Bako
authors.forename: Saidu
authors.initials: S
authors.lastname: Kadas
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Usman
authors.forename: Abubakar A
authors.initials: AA
authors.lastname: Kullima
authors.forename: Joel Y
authors.initials: JY
authors.lastname: Moruppa
references.citation: Am J Obstet Gynecol. 1978 Jul 15;131(6):598-605
references.pmid: 686046
references.citation: Obstet Gynecol Clin North Am. 1993 Jun;20(2):337-48
references.pmid: 8367136
references.citation: Fertil Steril. 1981 Oct;36(4):433-45
references.pmid: 7026295
references.citation: J Obstet Gynaecol. 2006 May;26(4):363-5
references.pmid: 16753692
references.citation: Semin Reprod Med. 2000;18(4):341-50
references.pmid: 11355792
references.citation: Am J Obstet Gynecol. 2000 Dec;183(6):1448-55
references.pmid: 11120509
references.citation: Am J Obstet Gynecol. 2007 Jun;196(6):601.e1-5; discussion 601.e5-6
references.pmid: 17547914
references.citation: Hum Reprod. 1999 Jul;14(7):1735-40
references.pmid: 10402378
references.citation: J Reprod Med. 2001 Oct;46(10):870-4
references.pmid: 11725729
references.citation: Hum Reprod. 2000 Dec;15(12):2663-8
references.pmid: 11098042
references.citation: Niger J Med. 2008 Oct-Dec;17(4):447-51
references.pmid: 19048765
references.citation: Fertil Steril. 1999 Jul;72(1):109-14
references.pmid: 10428157
references.citation: J Br Menopause Soc. 2006 Dec;12(4):153-7
references.pmid: 17178016
references.citation: Niger J Med. 2002 Jan-Mar;11(1):16-9
references.pmid: 12073294
references.citation: J Natl Med Assoc. 2005 Oct;97(10):1346-8
references.pmid: 16353656
references.citation: Arch Gynecol Obstet. 2011 Feb;283(2):311-5
references.pmid: 20098994
references.citation: Obstet Gynecol. 1997 Dec;90(6):967-73
references.pmid: 9397113
references.citation: Gynecol Obstet Fertil. 2002 Jun;30(6):474-82
references.pmid: 12146148
references.citation: Obstet Gynecol. 2002 Mar;99(3):426-32
references.pmid: 11864669