Laparoscopic myomectomy in Kenya : A 15 year retrospective review
Objectives: To evaluate the indications,operative techniques, outcomes, limitations and fertility outcomes following laparoscopic myomectomy.
Design: Retrospective case analysis
Setting: Various Private Hospitals in Kenya
Subjects: One thousand and forty three patients who underwent laparoscopic myomectomy
Results: The main indications for laparoscopic myomectomy in our review were Menorrhagia (52.1%), Primary Infertility (22.6 %), Secondary Infertility (14.3 %), Abdominal pain ( 8.2 % ) and pressure symptoms (2.8 %). The dominant myomas that were removed were intramural ( 45.4 %), subserous (34.6 %) and sub-mucous (19.9 %) of the cases respectively.
Conclusions: Laparoscopic Myomectomy can be performed safely and effectively by adequately trained and skilled Surgeons and offers all the advantages of laparoscopic surgery including less haemorrhage, quicker recovery and return to work. The clinical outcomes are good and there were no major complications. The fertility outcomes are comparable to open myomectomy with better outcomes for sub mucous fibroids and deep intra-mural fibroids indenting the uterine cavity.