Presentation and Surgical Treatment Outcomes of Patients with Uterine Fibroids in a Tertiary Centre, South-South Nigeria

Abstract

Introduction: Uterine leiomyomas frequently cause abnormal menstrual bleeding and are thought to be involved in infertility. Hence there is a need to identify the mode of presentation and management prevalent in our area to make recommendations on the measures to reduce the associated complications.

Materials and Methods: This is a retrospective review of all cases of symptomatic uterine leiomyoma managed surgically at the university of Calabar teaching hospital between January 1st, 2008 and December 31st, 2012.

Results: Uterine leiomyoma accounted for 31.6% of all gynaecological operations in UCTH. Of these, 72.9% of the patients were in their 3rd to 4th decade of life. Nulliparous women accounted for 70% of all cases reviewed. The most common reason for the presentation was infertility (30.7%), while haemorrhage was 18.7%. Majority of the patients were managed by myomectomy (85.7%). The  complications associated with surgical treatment seen in this study included wound infection (15.7%), haemorrhage (27.1%), pyrexia (12.1%), injury to the bladder (1.7%), ureteric injury (0.4%) and death (0.4%).

Conclusion: Surgery remains the most common management option in our environment. Poorly managed surgical treatment is the major cause of complications and therefore proper therapeutic options are paramount to secure the reproductive potential of the patient and reduce complications.

Keywords: Leiomyoma, Infertility, Complications.