OUTCOME OF ABDOMINAL MYOMECTOMY FOR UTERINE FIBROID AT SAHIWAL TEACHING HOSPITAL
Main Article Content
Keywords
Fibroid; Abdominal Myomectomy; Urinary Tract Infection.
Abstract
Background: Abdominal myomectomy is a widely utilized approach for alleviating symptoms associated with uterine fibroids. However, it carries potential risks, including infection, hemorrhage, and the possibility of converting to hysterectomy.
Objectives: This study aimed to evaluate the outcomes of abdominal myomectomy for uterine fibroids at Sahiwal Teaching Hospital, Sahiwal.
Study Design: Prospective cohort study.
Settings: Department of Obstetrics & Gynecology, Sahiwal Teaching Hospital, Sahiwal, Pakistan
Study Duration: 1st April 2023 to 30th September 2023.
Methodology: A total of 163 women, aged 20–40 years, who underwent abdominal myomectomy for symptomatic uterine fibroids, were included. The primary outcome variables—urinary tract infections (UTIs), intra-operative blood loss, wound infections, injury to the urinary bladder or bowel, and post-operative pyrexia—were assessed through clinical diagnosis (e.g., urine cultures for UTIs), intra-operative observations (e.g., blood loss), and daily post-operative monitoring (e.g., temperature checks for pyrexia). Data were analyzed using SPSS version 25.0, with descriptive statistics and stratification by age, BMI, hypertension, and diabetes.
Results: The study participants had a mean age of 29.85 ± 3.35 years. The most common complications observed were UTI (15.34%), intra-operative blood loss (19.02%), wound infections (12.22%), injury to the urinary bladder or bowel (3.68%), and post-operative pyrexia (11.04%). Stratification revealed that diabetes mellitus (DM) was significantly associated with increased rates of UTI (p = 0.014), intra-operative blood loss (p = 0.027), wound infections (p = 0.041), and pyrexia (p = 0.033). Additionally, patients with BMI > 25 had a higher incidence of pyrexia (p = 0.008).
Conclusion: Abdominal myomectomy carries significant complication risks, particularly for diabetic and obese patients, highlighting the need for preoperative glycemic control and weight management to optimize outcomes.
References
2. Yahaya UR, Dase E, Pius SM, Azeez OA, Lawan AI. Elective Total Abdominal Hysterectomy for Symptomatic Uterine Fibroids: A Perspective on Its Impact on Women’s Reproductive Health. Soft Tissue Sarcoma and Leiomyoma-Diagnosis, Management, and New Perspectives: IntechOpen; 2024. DOI: 10.5772/intechopen.1003631
3. Ahmad A, Kumar M, Bhoi NR, Badruddeen, Akhtar J, Khan MI, et al. Diagnosis and management of uterine fibroids: current trends and future strategies. Journal of basic and clinical physiology and pharmacology. 2023;34(3):291-310.
4. Uhunmwangho EA. Barriers to treatment of symptomatic uterine fibroids among African American women: Capella University; 2016.
5. Munro MG, Tchaikovski SN, Murji A. The epidemiology and pathogenesis of uterine fibroids. International Journal of Gynecology & Obstetrics. 2025. DOI: 10.1002/ijgo.70527
6. Narwal S, Vashist M, Kaushik R, Kalra V, Hooda R, Singh S. A Systematic Review on Uterine Leiomyoma: From Pathogenomics to Therapeutics. Soft Tissue Sarcoma and Leiomyoma-Diagnosis, Management, and New Perspectives. 2024. DOI: 10.5772/intechopen.1002877
7. Dimitratos SM, Swartz JR, Laugero KD. Pathways of parental influence on adolescent diet and obesity: a psychological stress–focused perspective. Nutrition reviews. 2022;80(7):1800-10. https://doi.org/10.1093/nutrit/nuac004
8. Paping A, Bluth A, Al Naimi A, Mhallem M, Kolak M, Jaworowski A, et al. Opportunities for, and barriers to, uterus‐preserving surgical techniques for placenta accreta spectrum. Acta obstetricia et gynecologica Scandinavica. 2025;104:8-19. DOI: 10.1111/aogs.14855
9. Milewska G, Ponikwicka–Tyszko D, Bernaczyk P, Lupu O, Szamatowicz M, Sztachelska M, et al. Functional evidence for two distinct mechanisms of action of progesterone and selective progesterone receptor modulator on uterine leiomyomas. Fertility and Sterility. 2024;122(2):341-51. https://doi.org/10.1016/j.fertnstert.2024.02.046
10. Paredes JS, Lee C-L, Chua PT. Myomectomy: choosing the surgical approach–a systematic review. Gynecology and Minimally Invasive Therapy. 2024;13(3):146-53. https://doi.org/10.1142/S266131822374078X
11. Loddo A, Sicilia G, Angioni S. Prevention, diagnosis, and management of complications in hysteroscopic myomectomy: a literature review. Gynecology and Pelvic Medicine. 2024;7(4):1-11. https://dx.doi.org/10.21037/gpm-23-27
12. Yamba YL. A survey of the intraoperative cell salvage in operating rooms at an academic hospital: University of the Witwatersrand, Johannesburg (South Africa); 2021.
13. Khan IA, Kanwal S, Najam A, Baloch H, Kamal N, Ahmed I. Impact of Trainees Involvement on Surgical Outcomes of Abdominal and Laparoscopic Myomectomy in Tertiary Care Hospital: Trainees' Impact on Myomectomy Outcomes. Pakistan Journal of Health Sciences. 2024:87-92. https://doi.org/10.54393/pjhs.v5i08.1753
14. Amin JJ. Assessment of Post-operative and Postdischarge Wound Infection After Abdominal Hysterectomy: Walden University; 2017.
15. Mettler L, Schollmeyer T, Tinelli A, Malvasi A, Alkatout I. Complications of uterine fibroids and their management, surgical management of fibroids, laparoscopy and hysteroscopy versus hysterectomy, haemorrhage, adhesions, and complications. Obstetrics and gynecology international. 2012;2012(1):791248. doi:10.1155/2012/791248
16. Zhang M, Feng J, Ma W, Qiu L, Wang D, Yang Z. Current status of fertility preservation procedures in gynecologic oncology: from a Chinese perspective. Journal of Assisted Reproduction and Genetics. 2025;42(2):635-45. https://doi.org/10.1007/s10815-024-03341-0
17. Imam K. Nationwide research on Increased Rate of UTI in an early age resulting in Endometriosis and Infertility and female reproductive health: Brac University; 2023.
18. Enabor OO, Bello FA. Surgical management of uterine fibroids in a tertiary hospital in south‑west Nigeria. Tropical Journal of Obstetrics and Gynaecology. 2020;37(1):156-9. DOI:10.4103/TJOG.TJOG_49_19
19. Mu J, Ni C, Wu M, Fan W, Liu Z, Xu F, et al. A retrospective study on risk factors for urinary tract infection in patients with intracranial cerebral hemorrhage. BioMed Research International. 2020;2020(1):1396705. https://doi.org/10.1155/2020/1396705
20. Wattanasiri K, Lattiwongsakorn W, Sreshthaputra R-a, Tongsong T. Incidence and Risk Factors of Post-operative Febrile Morbidity among Patients Undergoing Myomectomy. Medicina. 2023;59(5):990. https://doi.org/10.3390/medicina59050990
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Rashida Kousar
FCPS PGR, Sahiwal Teaching Hospital, Sahiwal, Pakistan
Saeeda Bano
FRCOG, MRCOG (UK) , FCPS (PAK), Associate Professor at Sahiwal Teaching Hospital, Sahiwal, Pakistan
Anum Yousaf
Senior Registrar at Sahiwal Teaching Hospital, Sahiwal, Pakistan
Sehrish Muzafar
Consultant Gynaecologist , Sahiwal Teaching Hospital, Sahiwal, Pakistan
Sidra Javed
MCPS Gynae, WMO, Sahiwal Teaching Hospital, Sahiwal, Pakistan
Abeerah Zafar
Senior Registrar at Sahiwal Teaching Hospital, Sahiwal, Pakistan
Tayyaba Yasin
Molecular Biology and Biotechnology at The University of Lahore, Lahore, Pakistan.
