Conversion to hysterectomy during organ-preserving operation for uterine fibroids

Abstract

Introduction: Uterine fibroids are the most common benign tumors in the female reproductive tract during the reproductive period. Among the options of the treatment spectrum, myomectomy is always considered one of the best choices in the management of women with symptomatic uterine fibroids who wish to preserve future fertility. The risk factors for conversion to subtotal hysterectomy during organpreserving operations are under evaluation. The aim: The goal of this study was to demonstrate a retrospective review of incidence and indications to conversion to hysterectomy during organ-preserving operation for uterine myomas. Materials and methods: 341 patients were subjected to organ-preserving operations for uterine myomas from 1994 to 2011. The mean age was 33.2±0.3 (it ranged from 17 to 53 years). The myoma size was 11.5±0.2 (from 4 to 24 weeks). Indications for surgical treatment represented: metrorrhagies 31,8% (n= 109), pain 32,9% (n=112), progressive myoma growth 19,7% (n=67). Sterility 12,6% (n-43), preparing to IVF 0,9% (n=3). Results: The number of enucleated fibroids ranged from 1 to 26 (mean 2.6±0.2). Conversion to subtotal hysterectomy was done in 3 cases (0,9%), because of diffuse leiomiomatosis. There was no conversion because of surgical techniques. Conclusions: This study demonstrates that diffuse leiomiomatosis is the main indication for subtotal hysterectomy during organ-preserving operations for uterine fibroids.