Clinical pattern and management outcome of uterine fibroids seen in a private specialist hospital in southeast Nigeria.

  • NJA Obiechina
  • JO Ugboaja
  • CO Ezeama
  • EN Monago
Keywords: Fibroids, private facilities, presentation, outcome

Abstract

Background
Uterine fibroid is the commonest tumour affecting women of reproductive age in our locality. Owing to the significant role played by private
health facilities in healthcare delivery in the developing countries, most of these cases will be handled at the private facilities. Therefore a
constant review of pattern of presentation and treatment outcome in these hospitals is necessary to improve on the efficiency of the diagnosis and
treatment of this common condition.
Objective: To ascertain the pattern of clinical presentation, findings at surgery and treatment outcome of cases of uterine fibroids managed by
abdominal myomectomy in Private Specialist Hospital in Southeast Nigeria, over a 5-year period.
Setting: Grace Specialist hospital Onitsha, South East of Nigeria.
Materials and methods: This prospective descriptive study was carried out between 1st January 2003 and 31st December 2007. Patients who
were booked for myomectomy on account of uterine fibroids were recruited for the study. The diagnosis of uterine fibroids was made both
clinically and use of ultrasound. Biodata, clinical presentation, findings at surgery, complications following surgery and duration of hospital stay
were recorded. The data was analyzed with the epi info statistical package, version 2006.
Result: The mean age of the patients was 32.9±6.5 years. Majority of the patients were nulliparous (7.0%). The commonest presenting symptom
was menorrhagia (44.40%) and majority (54.2%) of the women had medium sized fibroids (uterine size 12-16weeks).The total number of fibroid nodules ranged from 1-148(mean= 11) with weight varying between 25g to 3850g. Most (68.1%) of the patients had a combination of
intramural, subserous, submucous fibroids and intraligamentary fibroids. The transverse abdominal incision was used in majority (51.4%) of the
patients. The estimated mean blood loss was 500±150mls, with a mean drop in haemoglobin concentration of 1.4 +0.6g/dl. 22.20% of the
patients received blood transfusion intraoperatively. Postoperative complications were encountered in 11.80% of patients and constitute mainly of febrile morbidity (5.6%) and wound infection (2.8%). The mean hospital stay was 9.1=3.6 days. No mortality was recorded.
Conclusion: Most of the women managed for uterine fibroids were nulliparous and presented mainly with menorrhagia and multiple fibroids
nodules. Myomectomy as a form of treatment is safe but may be attended by a high level of blood transfusion. Efforts should be made to reduce
intraoperative blood loss by the use of tourniquet and the gonadotrophin releasing hormone analogues.
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eISSN: 1119-0388