Myomectomy: technique and current indications.
Identifieur interne : 000759 ( PubMed/Checkpoint ); précédent : 000758; suivant : 000760Myomectomy: technique and current indications.
Auteurs : Hajanirina Rakotomahenina [Madagascar] ; José Rajaonarison [Madagascar] ; Lufee Wong [Australie] ; Jean-Luc Brun [France]Source :
- Minerva ginecologica [ 1827-1650 ] ; 2017.
Abstract
Uterine fibroids are the commonest benign tumor of the female genital tract. They affect a significant proportion of reproductive aged women and may cause excessive menstrual bleeding, pelvic pain or pressure, and adversely affect reproductive outcomes. However, many women remain asymptomatic. Fibroids are the first indication for hysterectomy, but myomectomy is the most suitable surgical option for women who desire preservation of their fertility potential. Only a selected group of women of childbearing age will benefit from a myomectomy, as the consequences of myomectomy on reproductive function have remained controversial. The purpose of this paper was to review the main surgical approaches for myomectomy, and discuss evidence-based indications for myomectomy in women with fibroids, especially with regards to its impact on fertility and reproductive outcomes. A critical review of the literature pertaining to the surgical approaches of myomectomy and the indications for myomectomy was performed, focusing on their impact on fertility and reproductive outcomes. Myomectomy is useful for the treatment of symptomatic fibroids and in selected women with infertility. Symptomatic submucosal fibroids are classically treated by hysteroscopic resection. Symptomatic intramural and subserosal fibroids may be treated by myomectomy, either by laparotomy or laparoscopy depending on their number and size. Prophylactic myomectomy is not recommended for preventing obstetrical complications or the risk of leiomyosarcoma. Although fibroids may have a negative effect on fertility, only the removal of submucosal fibroids has been consistently shown to improve spontaneous fertility or outcomes of assisted reproduction technology.
DOI: 10.23736/S0026-4784.17.04073-4
PubMed: 28447445
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jean-luc.brun@chu-bordeaux.fr.</nlm:affiliation><country wicri:rule="url">France</country><wicri:regionArea>Department of Obstetrics and Gynecology, University Hospital Pellegrin, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author></analytic><series><title level="j">Minerva ginecologica</title><idno type="eISSN">1827-1650</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Uterine fibroids are the commonest benign tumor of the female genital tract. They affect a significant proportion of reproductive aged women and may cause excessive menstrual bleeding, pelvic pain or pressure, and adversely affect reproductive outcomes. However, many women remain asymptomatic. Fibroids are the first indication for hysterectomy, but myomectomy is the most suitable surgical option for women who desire preservation of their fertility potential. Only a selected group of women of childbearing age will benefit from a myomectomy, as the consequences of myomectomy on reproductive function have remained controversial. The purpose of this paper was to review the main surgical approaches for myomectomy, and discuss evidence-based indications for myomectomy in women with fibroids, especially with regards to its impact on fertility and reproductive outcomes. A critical review of the literature pertaining to the surgical approaches of myomectomy and the indications for myomectomy was performed, focusing on their impact on fertility and reproductive outcomes. Myomectomy is useful for the treatment of symptomatic fibroids and in selected women with infertility. Symptomatic submucosal fibroids are classically treated by hysteroscopic resection. Symptomatic intramural and subserosal fibroids may be treated by myomectomy, either by laparotomy or laparoscopy depending on their number and size. Prophylactic myomectomy is not recommended for preventing obstetrical complications or the risk of leiomyosarcoma. Although fibroids may have a negative effect on fertility, only the removal of submucosal fibroids has been consistently shown to improve spontaneous fertility or outcomes of assisted reproduction technology.</div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">28447445</PMID><DateCreated><Year>2017</Year><Month>04</Month><Day>27</Day></DateCreated><DateRevised><Year>2017</Year><Month>06</Month><Day>13</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1827-1650</ISSN><JournalIssue CitedMedium="Internet"><Volume>69</Volume><Issue>4</Issue><PubDate><Year>2017</Year><Month>Aug</Month></PubDate></JournalIssue><Title>Minerva ginecologica</Title><ISOAbbreviation>Minerva Ginecol</ISOAbbreviation></Journal><ArticleTitle>Myomectomy: technique and current indications.</ArticleTitle><Pagination><MedlinePgn>357-369</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.23736/S0026-4784.17.04073-4</ELocationID><Abstract><AbstractText>Uterine fibroids are the commonest benign tumor of the female genital tract. They affect a significant proportion of reproductive aged women and may cause excessive menstrual bleeding, pelvic pain or pressure, and adversely affect reproductive outcomes. However, many women remain asymptomatic. Fibroids are the first indication for hysterectomy, but myomectomy is the most suitable surgical option for women who desire preservation of their fertility potential. Only a selected group of women of childbearing age will benefit from a myomectomy, as the consequences of myomectomy on reproductive function have remained controversial. The purpose of this paper was to review the main surgical approaches for myomectomy, and discuss evidence-based indications for myomectomy in women with fibroids, especially with regards to its impact on fertility and reproductive outcomes. A critical review of the literature pertaining to the surgical approaches of myomectomy and the indications for myomectomy was performed, focusing on their impact on fertility and reproductive outcomes. Myomectomy is useful for the treatment of symptomatic fibroids and in selected women with infertility. Symptomatic submucosal fibroids are classically treated by hysteroscopic resection. Symptomatic intramural and subserosal fibroids may be treated by myomectomy, either by laparotomy or laparoscopy depending on their number and size. Prophylactic myomectomy is not recommended for preventing obstetrical complications or the risk of leiomyosarcoma. Although fibroids may have a negative effect on fertility, only the removal of submucosal fibroids has been consistently shown to improve spontaneous fertility or outcomes of assisted reproduction technology.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Rakotomahenina</LastName><ForeName>Hajanirina</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Obstetrics and Gynecology, University Hospital of Fianarantsoa, Fianarantsoa, Madagascar.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rajaonarison</LastName><ForeName>José</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Obstetrics and Gynecology, University Hospital of Mahajanga, Mahajanga, Madagascar.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wong</LastName><ForeName>Lufee</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Obstetrics and Gynecology, Monash Medical Centre, Clayton, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brun</LastName><ForeName>Jean-Luc</ForeName><Initials>JL</Initials><AffiliationInfo><Affiliation>Department of Obstetrics and Gynecology, University Hospital Pellegrin, Bordeaux, France - jean-luc.brun@chu-bordeaux.fr.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>04</Month><Day>26</Day></ArticleDate></Article><MedlineJournalInfo><Country>Italy</Country><MedlineTA>Minerva Ginecol</MedlineTA><NlmUniqueID>0400731</NlmUniqueID><ISSNLinking>0026-4784</ISSNLinking></MedlineJournalInfo></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>4</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>4</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>4</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28447445</ArticleId><ArticleId IdType="pii">S0026-4784.17.04073-4</ArticleId><ArticleId IdType="doi">10.23736/S0026-4784.17.04073-4</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Australie</li><li>France</li><li>Madagascar</li></country><region><li>Aquitaine</li><li>Nouvelle-Aquitaine</li></region><settlement><li>Bordeaux</li></settlement></list><tree><country name="Madagascar"><noRegion><name sortKey="Rakotomahenina, Hajanirina" sort="Rakotomahenina, Hajanirina" uniqKey="Rakotomahenina H" first="Hajanirina" last="Rakotomahenina">Hajanirina Rakotomahenina</name></noRegion><name sortKey="Rajaonarison, Jose" sort="Rajaonarison, Jose" uniqKey="Rajaonarison J" first="José" last="Rajaonarison">José Rajaonarison</name></country><country name="Australie"><noRegion><name sortKey="Wong, Lufee" sort="Wong, Lufee" uniqKey="Wong L" first="Lufee" last="Wong">Lufee Wong</name></noRegion></country><country name="France"><region name="Nouvelle-Aquitaine"><name sortKey="Brun, Jean Luc" sort="Brun, Jean Luc" uniqKey="Brun J" first="Jean-Luc" last="Brun">Jean-Luc Brun</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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