Research Article Surgical Outcomes of Cesarean Sections after Laparoscopic Myomectomy: A Comparison with Open Myomectomy and Other Cesarean

Abstract

Background Myomas are a common gynecologic disease. Laparoscopic myomectomy procedures have been performed more frequently in recent years. We were unable to find any reports pertaining to actual surgical findings such as adhesions during cesarean section after laparoscopic myomectomy. We compared surgical outcomes at the time of cesarean section in individuals who underwent laparoscopic myomectomy at our hospital with those who other cesarean sections. Methods From 1995 to 2023, the surgical outcomes of 49 patients who underwent laparoscopic myomectomy at our hospital and later underwent cesarean section for singleton term delivery were compared with those of 20 singleton full term cesarean sections after open myomectomy, 86 singleton full term previous cesarean sections without previous laparotomy, and 43 cesarean sections after breech delivery. In addition, patient background and surgical outcomes for cesarean sections after laparoscopic myomectomy and open myomectomy were compared between the two groups. Results In a comparison of blood loss among the four groups, cesarean sections after laparoscopic myomectomy and open myomectomy resulted in significantly more blood loss than breech position cesarean sections. On the other hand, a comparison between laparoscopic myomectomy and open myomectomy showed that the recurrence rate of uterine fibroids upon cesarean section was significantly higher after laparoscopic myomectomy. Adhesions at cesarean section were more common with open myomectomy and myometrial dimpling/thinning was more frequent after laparoscopic myomectomy, but the difference was not statistically significant. There were no cases of uterine rupture during pregnancy in our patients. Conclusions Practitioners performing cesarean sections need to be very careful about the incidence of bleeding during cesarean sections after laparoscopic myomectomy. Also, practitioners performing laparoscopic myomectomy need to be very careful about adhesion, dimpling, thinning and recurrence.