Can we consider cesarean myomectomy as a safe procedure without long-term outcome?

J Matern Fetal Neonatal Med. 2017 Aug;30(15):1855-1860. doi: 10.1080/14767058.2016.1228057. Epub 2016 Sep 9.


Aim: 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.

Conclusion: The recurrence of myoma was relatively low following CM. Subsequent pregnancy is protective for recurrence of myoma without increased adhesion formation and obstetric complications.

Keywords: Cesarean section; complication; myomectomy; outcome; pregnancy.

MeSH terms

  • Adolescent
  • Adult
  • Blood Loss, Surgical / statistics & numerical data
  • Blood Transfusion / statistics & numerical data
  • Cesarean Section / adverse effects
  • Cesarean Section / methods*
  • Female
  • Hematocrit
  • Hemoglobins / analysis
  • Humans
  • Leiomyoma / surgery
  • Neoplasm Recurrence, Local / epidemiology
  • Operative Time
  • Postoperative Complications / epidemiology
  • Pregnancy
  • Retrospective Studies
  • Tissue Adhesions / epidemiology
  • Treatment Outcome*
  • Uterine Myomectomy / adverse effects
  • Uterine Myomectomy / methods*
  • Uterine Neoplasms / surgery
  • Young Adult


  • Hemoglobins