The Journal of the American Association of Gynecologic Laparoscopists
Case ReportsUterine Rupture after Laparoscopic Myomectomy
Section snippets
Case Report
A 36-year-old woman had a 5-year history of infertility and one early miscarriage. Transvaginal ultrasound revealed a 4-cm pedunculated myoma on the posterior wall of the uterus; hysteroscopy showed normal anatomy. Laparoscopy confirmed the findings of transvaginal ultrasound. The lesion was only 1 to 2 cm from tubal junctions, pedunculated, with a 2- to 3-cm pedicle. Numerous implants of endometriosis were present in the pouch of Douglas and on both ovaries. Myomectomy was performed, with
Discussion
Several issues might be discussed with regard to this report, such as complications of uterine rupture during subsequent pregnancies, differences between laparoscopy and laparotomy, and whether the time between myomectomy and infertility treatment is important. We can only raise the issues, not provide answers.
The risk of uterine rupture after traditional abdominal and laparoscopic myomectomies is low. The only random ized study to our knowledge comparing fertility and obstetric outcome between
References (6)
Delayed childbearing
Eur J Obstet Gynecol
(1997)Myomectomy for fertility enhancement and preservation
Fertil Steril
(1992)- et al.
Effect of uterine leiomyomata on the results of in-vitro fertilization treatment
Hum Reprod
(1995)
Cited by (58)
Time to conceive after myomectomy: should we advise a minimum time interval? A systematic review
2021, Reproductive BioMedicine OnlineCitation Excerpt :The 43 studies were from 15 different countries; 29 (67.4%) were retrospective studies (Bernardi et al., 2014; Borja de Mozota et al., 2014; Connolly et al., 2000; Dessolle et al., 2001; Fauconnier et al., 2000; Fukuda et al., 2013; Huberlant et al., 2020a; Kang et al., 2020; Kelly et al., 2008; Koo et al., 2015; Kumakiri et al., 2005, 2008; Lebovitz et al., 2019; Malzoni et al., 2010; Morita and Asakawa, 2006; Paul et al., 2006; Pepin et al., 2020; Pitter et al., 2015, 2013; Pundir et al., 2015; Rovio and Heinonen, 2012; Seinera et al., 2000; Seracchioli et al., 2006; Soriano et al., 2003; Tian et al., 2015; Tsuji et al., 2016; Tusheva et al., 2013; Yoshino et al., 2012; Zhang and Hua, 2014), nine (20.9%) were prospective or cohort studies (Cela et al., 2013; Chang et al., 2009; Chen et al., 2017; Lönnerfors and Persson, 2009, 2011; Nishida et al., 2014; Plotti et al., 2008; Tinelli et al., 2012; Wu et al., 2020), and five (11.6%) were prospective randomized studies (Kameda et al., 2018; Kim et al., 2016; Kubinova et al., 2012; Mara et al., 2008; Samejima et al., 2015). In addition, 37 articles presented summaries or case reports of uterine rupture during pregnancy after myomectomy (n = 37) (Abbas et al., 2018; Asakura et al., 2004; Banas et al., 2005; Cho, 2018; Foucher et al., 2000; Fukutani et al., 2017; Goynumer et al., 2009; Grande et al., 2005; Hagneré et al., 2011; Hasbargen et al., 2002; Hawkins et al., 2018; Hortu et al., 2015; Iemura et al., 2015; Jakiel et al., 2002; Kacperczyk et al., 2016; Kim et al., 2016; Kiseli et al., 2013; Kuwata et al., 2011; Lieng et al., 2004; Mahajan et al., 2019; Matsunaga et al., 2004; Nkemayim et al., 2000; Okada et al., 2016; Oktem et al., 2001; Pakniat et al., 2016; Parker et al., 2007; Pistofidis et al., 2012; Skrablin et al., 2005; Song et al., 2015; Sutton et al., 2016; Tauchi et al., 2016; Tomczyk et al., 2018; Torbé et al., 2012; Vimercati et al., 2017; Wachira et al., 2019; Wu et al., 2018; Yazawa et al., 2018). Altogether, the selected articles represented 7335 myomectomies performed for various conditions: infertility, heavy menstrual bleeding, pelvic discomfort.
Mesenchymal stem cells and their conditioned medium can enhance the repair of uterine defects in a rat model
2018, Journal of the Chinese Medical AssociationCitation Excerpt :Extensive uterine surgery, such as removal of huge uterine myomas or adenomyomas, can occasionally result in uterine rupture during subsequent pregnancy, particularly when the surgery is performed laparoscopically.1–8
Pregnancy Outcomes and Risk Factors for Uterine Rupture After Laparoscopic Myomectomy: A Single-Center Experience and Literature Review
2015, Journal of Minimally Invasive GynecologyCitation Excerpt :Because of massive hemorrhage, a total hysterectomy was performed, which resulted in fetal death. The 21 articles [10–30] published on uterine rupture after LSM describe a total of 34 events. The results of reviewing cases of uterine rupture from the published reports in the present study are shown in Table 4.
Perspectives of Obstetricians on Labour and Delivery After Abdominal or Laparoscopic Myomectomy
2014, Journal of Obstetrics and Gynaecology CanadaCitation Excerpt :Despite the dogma that uterine rupture is more likely after a myomectomy with entry into the uterine cavity, there has been no definitive study proving this.3,15 Evidence of uterine rupture after myomectomy is scarce and consists mostly of case reports, with uterine rupture occurring mostly before labour between the gestational ages of 28 weeks and 36 weeks.13,16–20 Uterine rupture can also occur after uterine surgery such as dilatation and curettage and laparoscopy for endometriosis, and these are not otherwise an indication for CS.21
Current role of conservative surgery
2013, Medicina ClinicaSpontaneous uterine rupture after myomectomy. Case report and review of the literature
2011, Journal de Gynecologie Obstetrique et Biologie de la Reproduction