Caesarean myomectomy in Kano northern Nigeria

Abstract

Objective: To evaluate the feasibility and outcome of caesarean myomectomy.
Patients and Methods: A retrospective study of cases of caesarean myomectomy at the Aminu Kano Teaching Hospital, Kano, Nigeria, a tertiary health facility in a developing country between January 1998 and December 2004.
Outcome Measures: Age and parity of the women, number, size and location of fibroids, duration of operation, estimated blood loss, postoperative complications and duration of hospital stay.
Results: Sixteen cases of caesarean myomectomy were done during the study period using the tourniquet method. It involved the enucleation of single and multiple myomas during lower segment caesarean section (LSCS).The mean age of the women was 29.0 + 1.90 years. The mean duration of caesarean myomectomy was 54.75 + 4.57 minutes, while the mean duration of LSCS only in our unit was 42.0 + 3.16 minutes. There was no statistically significant difference in the mean duration of operation between the two groups (t = 15.94, df = 1550, P > 0.05). The mean blood loss during caesarean myomectomy was 460.31 + 81.74mls, while the mean blood loss during LSCS in our unit was 355.0 + 60.25mls. There was no statistically significant difference in the mean blood loss between the two groups (t = 0.85, df = 1550, P > 0.05). The postoperative period was uneventful in all the cases. They were all discharged on the 6th postoperative day. They were followed up until 3 months post-operation in the postnatal clinic.
Conclusion: Caesarean myomectomy seems to be feasible and safe in selected cases when a tourniquet is applied.