Open AccessTherapeutic approach of uterine leiomyoma; choosing the most appropriate surgical option
Author(s) -
Anca Daniela Stănescu,
Mihai George Loghin,
Liana Pleș,
Daniela Gabriela Bălan,
Ioana Păunică,
Oana Balalau
Publication year - 2021
Publication title -
journal of clinical and investigative surgery
Language(s) - English
Resource type - Journals
ISSN - 2559-5555
DOI - 10.25083/2559.5555/6.1.1
Subject(s) - medicine , leiomyoma , hysterectomy , uterine leiomyoma , surgery , curettage , pelvic pain , laparoscopy , asymptomatic , malignancy , endometriosis , abdominal pain , gynecology
The most common benign pelvic tumor in young women is uterine leiomyoma. It is often asymptomatic, but can cause symptoms such as pelvic-abdominal pain, vaginal bleeding, urinary and intestinal transit disorders. If there is a suspicion of malignancy, it is necessary to perform fractional uterine curettage to establish the histopathological diagnosis.The surgical treatment of uterine leiomyoma includes several procedures: myomectomy, subtotal or total hysterectomy. The procedure will be chosen depending on the patient's particularities: BMI, uterine size, leiomyoma location, surgical history or other associated pathologies.Laparoscopic hysterectomy has a 45-minute shorter duration of intervention than vaginal hysterectomy, and the conversion rate to the open procedure is lower.Laparoscopically treated cases have fewer postoperative complications compared to other surgical procedures and have a shorter hospitalization and recovery time.The recurrence rate of uterine leiomyoma is similar for both laparoscopic and open abdominal approach, and the frequency of long-term complications such as adhesion syndrome or pelvic pain is higher after the latter.