Rupture rates after laparoscopic myomectomy using single stitches in only one layer

Myomectomy is a common laparoscopic procedure and is often used in patients with infertility, bleeding disorders and other symptoms caused by leiomyomas. We present a case series report based on a retrospective audit conducted from January 2001 up to December 2006 in our department. From 451 patients laparoscopically operated for leiomyomas, we identified only 59 patients operated due to infertility reasons. We report the post-operative rates of pregnancy and mode of delivery after a median follow-up of 40 months post-operatively. Laparoscopic technique and obstetrical outcome is discussed with recent literature review. The average number of removed fibroids was 2. The mean weight of the leiomyomas was 94.3 g. The cavum uteri was opened in eight patients. Overall, 42 out of 59 women delivered 51 live newborn babies, yielding a post-operative success rate of 71%. The miscarriage rate post-operatively was 8 out of 60 pregnancies (13%). In patients with leiomyomas identified as infertility cofactor, laparoscopic management is a convincing therapeutic approach. In our experience, conception rate was 71%, and complications during pregnancy were limited to 4% of the patients. Risk of uterine rupture during labour was present in 4% of the cases, implying that mode of delivery should always be discussed with the patient.