title: Can we consider cesarean myomectomy as a safe procedure without long-term outcome?
abstract: OBJECTIVE
  To investigate short- and long-term outcomes in women undergoing cesarean myomectomy (CM).
  
  
  METHODS
  This was a retrospective study that explored short-term outcomes of women, who underwent cesarean operations with or without myomectomies (CM controls) in a single tertiary center throughout a 6-year-period. For long-term outcomes, the mean duration of follow-up was 6.3 ± 1.0 years.
  
  
  RESULTS
  There were no differences among the CM (n= 91) and control groups (n = 60) considering mean change in hemoglobin and hematocrit levels, hemorrhage, as well as requirement for blood transfusions with a slightly increased operative time. Multiple myomas, and cervical and cornual localization were associated with an increased drop of hemoglobin and hematocrit (p < 0.05). Subsequent pregnancy and recurrence rates were 35% (32/91) and 5.5% (5/91), respectively. Preterm delivery (n = 1, 3.1%), uterine dehiscence (n = 1, 3.1%), placenta previa (n = 1, 3.1%) and mild-to-severe post-CM adhesions (n = 8, 25%) were observed in subsequent pregnancies. Recurrence was identified in five of the nonpregnant (5.5%) women, and three of these (4.1%) underwent an additional major surgery. There was no recurrence in subsequent pregnancies.
  
  
  CONCLUSIONS
  The recurrence of myoma was relatively low following CM. Subsequent pregnancy is protective for recurrence of myoma without increased adhesion formation and obstetric complications.
authors.affiliation: a Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Perinatology , Suleyman Demirel University , Isparta , Turkey.
authors.forename: Mehmet Ozgur
authors.initials: MO
authors.lastname: Akkurt
authors.affiliation: a Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Perinatology , Suleyman Demirel University , Isparta , Turkey.
authors.forename: And
authors.initials: A
authors.lastname: Yavuz
authors.affiliation: a Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Perinatology , Suleyman Demirel University , Isparta , Turkey.
authors.forename: Serenat
authors.initials: S
authors.lastname: Eris Yalcin
authors.affiliation: b Isparta Maternity and Children's Hospital, Department of Obstetrics and Gynecology , Isparta , Turkey , and.
authors.forename: Iltac
authors.initials: I
authors.lastname: Akkurt
authors.affiliation: c College of Arts and Sciences, University of Miami , Coral Gables , FL , USA.
authors.forename: Ozerk Turel
authors.initials: OT
authors.lastname: Turan
authors.affiliation: a Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Perinatology , Suleyman Demirel University , Isparta , Turkey.
authors.forename: Yakup
authors.initials: Y
authors.lastname: Yalcin
authors.affiliation: a Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Perinatology , Suleyman Demirel University , Isparta , Turkey.
authors.forename: Mekin
authors.initials: M
authors.lastname: Sezik
mesh_terms: D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007889:Leiomyoma / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D011247:Pregnancy; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000453:epidemiology; D016896:Treatment Outcome; D063186:Uterine Myomectomy / Q000009:adverse effects / Q000379:methods*; D014594:Uterine Neoplasms / Q000601:surgery; D055815:Young Adult
chemical_list: D006454:Hemoglobins
keywords: Cesarean section; complication; myomectomy; outcome; pregnancy