title: Pregnancy outcomes after transvaginal myomectomy by colpotomy.
abstract: OBJECTIVE
  To examine long-term effects of transvaginal myomectomy by colpotomy on uterine ruptures, fertility and pregnancy outcome.
  
  
  METHODS
  Transvaginal myomectomy by colpotomy was performed for sixteen patients who had symptomatic uterine leiomyomas and wished to preserve their fertility. Data on possible pregnancies, infertility treatments, hysterectomies and other reoperations during a follow-up period of ten years were retrospectively collected from the hospital records. Those who had no outpatient contacts in the hospital records were interviewed by telephone.
  
  
  RESULTS
  Eight (50%) of the 16 patients tried actively to conceive and they produced 14 pregnancies: six of them had two pregnancies and two had one. The median interval between the transvaginal myomectomy and the first pregnancy was 17 months (range 14-68 months). All pregnancies were uneventful and ended in full-term delivery of a healthy infant. Uncomplicated vaginal delivery was recorded in 10 (71%), vacuum extraction in one (7%) and cesarean section in three (21%) out of 14 cases. Uterine rupture or heavy postpartal bleeding was not reported.
  
  
  CONCLUSIONS
  Pregnancies after transvaginal myomectomy by colpotomy were uneventful and no uterine ruptures were detected during a long-term follow-up. Pregnancy rates after the procedure appear to be similar to results after abdominal or laparoscopic myomectomy. Transvaginal myomectomy by colpotomy is a safe and feasible treatment option for selected patients wishing to preserve their ability to conceive.
authors.affiliation: Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland. paivi.rovio@pshp.fi
authors.forename: Päivi H
authors.initials: PH
authors.lastname: Rovio
authors.forename: Pentti K
authors.initials: PK
authors.lastname: Heinonen
mesh_terms: D000328:Adult; D002585:Cesarean Section; D020884:Colpotomy / Q000009:adverse effects*; D005260:Female; D005298:Fertility; D059247:Fertility Preservation; D006801:Humans; D007889:Leiomyoma / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D047929:Term Birth; D013997:Time Factors; D014594:Uterine Neoplasms / Q000601:surgery*; D014597:Uterine Rupture / Q000209:etiology; D014620:Vacuum Extraction, Obstetrical