Rationale for myomectomy in women with infertility, associated with uterine fibroid
V.A. KНOROLSKIY
Kuban State Medical University, 4 Sedin St., Krasnodar, Russian Federation, 350063
Regional Clinical Hospital №2, Perinatal Center, 6/2 Krasnykh Partizan St., Krasnodar, Russian Federation, 350012
Khorolskiy V.A. ― Cand. Med. Sc., Associate Professor of the Department of Obstetrics, Gynecology and Perinatology, Head of the Maternity Ward of the Perinatal Centre Regional Clinical Hospital № 2, tel. (861) 222-02-09, e-mail: pc@kkb2-kuban.ru
Uterine fibroids can cause infertility in women. In reproductive age, conservative treatment is preferable. Myomectomy is fraught with subsequent risks of postoperative scar inconsistency in case of pregnancy. The discussion on priority of laparotomic or laparoscopic access remains relevant to the present day. The article presents the current understanding of the appropriateness of myomectomy in women with infertility mainly preconditioned by uterine fibroid. Basing on the literature data analysis, the differentiated approaches to conservative, surgical methods of treatment, laparotomy or laparoscopy are justified.
Key words: uterine fibroid, infertility, myomectomy, laparoscopy, laparotomy.
REFERENCES
1. Radzinskiy V.E., Totchiev V.E. Mioma matki: kurs na organosokhranenie. Informatsionnyy byulleten’ [Uterine fibroids: a course on organosohranenie. Newsletter]. Moscow: Redaktsiya zhurnala StatusPraesens, 2014. 24 p.
2. Petrakova C.A., Buyanova S.N., Mgeliashvili M.V. Features myomectomy in the correction of reproductive health of women with uterine myoma. Rossiyskiy vestnik akushera-ginekologa, 2009, 1, pp. 30-35 (in Russ.).
3. Agarawal K., Agarawal L., Agarawal A., Agarawal V.K., Agarawal K.. NJIRM, 2011, 2 (3), pp. 11-14.
4. Laughlin S.K., Herrings A.H., Savitz D.A., Olsham A.F., Fielding J.R., Hartman K.E. et al. Pregnancy-related fibroid reduction. Fertil Steril, 2010, 94, pp. 2421-3.
5. Adamyan L.V. et al. Mioma matki: diagnostika, lechenie i reabilitatsiya. Klinicheskie rekomendatsii po vedeniyu bol’nykh [Uterine fibroids: diagnostics, treatment and rehabilitation. Clinical guidelines for the management of patients]. Moscow, 2014. 100 p.
6. Titchenko I.P. Klinicheskoe znachenie novykh ul’trazvukovykh diagnosticheskikh tekhnologiy v vybore taktiki lecheniya miomy matki vne i vo vremya beremennosti: avtoref. dis. … kand. med. nauk [The clinical significance of the new ultrasound diagnostic technologies in a choice of tactics of treatment of uterine fibroids is during pregnancy. Synopsis of dis. PhD med. sciences]. Moscow, 2007. P. 21.
7. Buyanova S.N., Yudina N.V., Gukasyan S.A. Rehabilitation of reproductive function in women with uterine fibroids, infertility and miscarriage. Rossiyskiy vestnik akushera-ginekologa, 2012, 5, pp. 67-71 (in Russ.).
8. Vilos G.A., Allaire C., Laberge Ph.-Y, Leyland N., ON H. The management of Uterine Leiomyomas. SOGC Clincal practice guidline No. 318, February 2015 (Replaces, No. 128, May 2003). J. Obstet. Gynaecol. Can, 2015, 37 (2), pp. 157-178.
9. Sultana R., Noor Sh., Nazar A.F., Abbasi N., Bashir R., Khan B., Saleem F. Safety of caesarean myomectomy. J. Ayub. Med. Coll. Abbottabad, 2012, 24 (2).
10. Brady P.C., Stanic A.K., Styer A.K. Uterine fibroids and subfertility: an update on the role of myomectomy. Curr. Opin. Obstet. Gynecol, 2013, Jun, 25 (3), pp. 255-9. doi: 10.1097/GCO.0b013e3283612188.
11. Bhave Chittawar P., Franik S., Pouwer A.W., Farquhar C. Minimally invasive surgical techniques versus open myomectomy for uterine fibroids. Cochrane Database of Systematic Reviews, 2014, issue 10, art. no.: CD004638. DOI: 10.1002/14651858.CD004638.pub3.
12. Mettler L., Schollmeyer Th., Tinelli A., Malvasi A., Alkatout I. Complications of Uterine Fibroids and Their Management, Surgical Management of Fibroids, Laparoscopy and Hysteroscopy versus Hysterectomy, Haemorrhage, Adhesions, and Complications. Obstetrics and Gynecology International Volume 2012 (2012), Article ID 791248, 8 p, http://dx.doi.org/10.1155/2012/791248.
13. Tinelli A., Hurst B.S., Hudelist G., Tsin D.A., Stark M., Mettler L., Guido M., Malvasi A. Laparoscopic myomectomy focusing on the myoma pseudocapsule: technical and outcome reports. Hum. Reprod, 2012, Feb, 27 (2), pp. 427-35. doi: 10.1093/humrep/der369. Epub 2011 Nov 16.
14. Sangha R., Strickler R., Dahlman M., Havstad S., Wegienka G. Myomectomy to conserve fertility: seven-year follow-up. J. Obstet. Gynaecol. Can, 2015, Jan, 37 (1), pp. 46-51.
15. Desai P., Patel P. Fibroids, Infertility and Laparoscopic Myomectomy. J. Gynecol. Endosc. Surg, 2011, Jan-Jun, 2 (1), pp. 36-42. doi: 10.4103/0974-1216.85280, PMCID: PMC3304294
16. Ramzy Abdel-Maguid I. Myomectomy before IVF: Which fibroids need to be removed? Middle East Fertility Society Journal, 2011, 16, pp. 38-44.
17. Hanom Husni Syam Pregnancy Outcomes Following Laparoscopic Myo-mectomy. World Journal of Laparoscopic Surgery, 2008, January-April, 1 (1), pp. 35-40.


