Indications and outcomes of abdominal myomectomy at a Nigerian Tertiary Hospital

Abdominal myomectomy is a common modality of treatment for large and symptomatic uterine fibroids in women who wish to retain their fertility. While it is the commonest conservative surgical procedure in such patients, it may still be associated with complications. The study was aimed at determining the indications and factors associated with development of complication in patients that undergo abdominal myomectomy. It was a descriptive retrospective study of patients who had abdominal myomectomy at the Federal Medical Centre, Yenagoa, Bayelsa state, Nigeria from the 1st of January 2018 to the 31st of December 2020. Over the 3-year study period, 391 gynaecological surgeries were performed, of which 89 abdominal myomectomies accounted for 22.8% of surgeries. Seventy-six case records out of the 89 case records were retrieved for analysis, giving a retrieval rate of 85.4%. A significant number of the women (39.5%) were in the 35–39 years age group and slightly above half of the women (55.3%) were nulliparous. Abdominal mass was the leading indication (65.8%), followed by heavy menstrual bleeding (13.2%). There were intra-operative complications and postoperative complications in 19.7% and 26.3% of patients respectively. The most common intra-operative complication was bleeding requiring blood transfusion. The notable post-operative complications were post-operative anaemia, postoperative pyrexia and wound infection in decreasing order. Outcome of abdominal myomectomy is generally favourable once the factors that lead to complications are promptly identified and addressed. Nevertheless, patients should be counselled preoperatively on the risk of blood loss and the possibility of blood transfusion.