Short summary

Does myomectomy removal transabdominal increase complication rate similar to trans abdominal hysterectomy? Furthermore,the healing process og uterine dissection may cause weakness of the myometrium, but how fast does thes incision heal and does it matter in respect to fertility?

Rationale

It is wellknown that abdominal hysterectomy  is associated with higher risk of complications compared to laparoscopic hysterectomy. However, whether removal of myomas from the uterus transabdominal has not been evaluated, especially if this procedure is accociated with a complicatiuon rate similar to transabdominal hysterectomy, where a similar abdominal incision is used.

The laparoscopic assisted open abdominal procedure in order to remove trans abdominal myomas (small incision <5 cm) has been introduced in the Department of Obstetrics and Gynecology, Odense University Hospital during recent years in order to avoid morcellation and thereby the risk of spreading tissue (although seldom, thereby minimizing the risk of disseminating malignant tissue). This implies a laparoscopic removal followed by an abdominal incision and retraction of the fibroids within a bag.  Howwever, we do not know if this procedure are associated with similar complication rates as abdominal hysterectomy.

Furthermore, myomectomy may cause harm to the uterus as observed following cesarean section, where approximately 90% of all cases develop a niche (scar). The importance of this defect is not known, but may increase the risk of uterine rupture during following pregnancies. Whether a scar in the myometrium following myomectomy increases the risk of uterine rupture is not know. 

The impact of myomectomy and especially removal of myoma has been know to increase fertility but whether this in compromised if the endometrial cavity is opened during myomectomy is not known

Description of the cohort

Women who had undergone myomectomy

Data and biological material

Ultrasound evaluation will be performed using a GE Medical or similar for evaluation of the myometrium. A datasheet will be developed in order to include the above-mentioned data. (see the  CRF).

Medical record in relation to demographic variables and myomectomy

Resuls from ultrasound uterinescan mini hysteroscopy