Outcomes of Cesarean Myomectomy Using Novel and Safe Uterine Isthmic Circumferential Technique

Abstract

Background To evaluate the feasibility and safety of performing myomectomy during cesarean delivery using a novel bleeding-reducing suture technique.Methods This retrospective cohort study included pregnant women with intramural uterine fibroids. A total of 120 patients were divided into two groups: Group A consisted of women who underwent myomectomy during cesarean section between January 2020 and June 2024, and Group B included women who underwent cesarean section alone without myomectomy. The following data were obtained from hospital records and compared between the groups: maternal age, gravidity, parity, myoma size, gestational age at time, preoperative and postoperative hemoglobin (Hb) levels, need for blood transfusion, hospital stay, and duration of surgery. The primary outcome of the study was the change in Hb levels before and after the operation.Results The demographic and laboratory characteristics of 120 pregnant women with intramural leiomyomas who underwent either cesarean myomectomy or cesarean section alone were analyzed. Of these, 60 underwent cesarean section alone, while 60 underwent cesarean section with myomectomy. No statistically significant difference was found between the two groups in terms of preoperative Hb, postoperative 24-hour Hb, or Hb decrease (p = .240, p = .270, and p = .420, respectively). Similarly, there was no significant difference in operation duration (p = .160). A weak but statistically significant negative correlation was observed between myoma size and gestational age at delivery (r = −0.21, p = .0009). No statistically significant correlations were found between myoma size and either operation time or hospital stay.Conclusion Cesarean myomectomy appears to be a feasible and safe option when performed using the bleeding-reducing uterine isthmic circumferential suture technique. However, further multicenter studies with larger sample sizes are required to confirm these findings before recommending cesarean myomectomy as a routine approach.