Surgical management of uterine fibroids at Aminu Kano teaching hospital, Kano, Nigeria: a 5 year review
Background: Uterine fibroids are the most common pelvic tumors. They account for a significant number of gynecological consultations. Prevalence, presentation and outcome of treatment vary in different communities.
Objectives: To determine the prevalence and clinical presentation of uterine fibroids, and the morbidity associated with surgical management of uterine fibroids at Aminu Kano Teaching Hospital, Kano.
Study design: Retrospective study of all the cases of uterine fibroids that were surgically managed in Aminu Kano Teaching Hospital, Kano between 1st January 2006 and 31st December 2010.
Results: The period prevalence of uterine fibroids found in this study was 3.1%, 8.3% of gynecological operations were for fibroids. Main presentations were menstrual irregularities 75.9%, abdominal swelling 51.9%, lower abdominal pain 46.5%, dysmenorrhea 29.1%, infertility 20.3%. The postoperative complication of anemia occurred in 34.1% of patients who had myomectomy and 14.6% of those who had hysterectomy. Anemia was 3 times more likely to occur with myomectomy (OR 3.02, CI 1.69-3.56, P <0.05). Pyrexia occurred in 31.2% of patients who had myomectomy and 12.4% of those who had hysterectomy. It was 3 times more likely to occur following myomectomy than hysterectomy (OR 3.21, CI 1.74-5.93, P <0.05).Wound infection occurred in 13.8% and 12.4% of patients who had myomectomy and hysterectomy respectively, UTI in 6.5% and 5.6% of patients who had myomectomy and hysterectomy . They both showed no significant statistical difference between myomectomy and hysterectomy (for wound infection OR 1.13, CI 0.56-2.29, P >0.05 and for UTI OR 1.17, CI 0.42-3.23, P >0.05).
Conclusion: The prevalence and presentation of uterine fibroids found in this study is similar to the finding of other studies from Northern Nigeria. The most common presentations were menorrhagia and lower abdominal swelling, and not infertility. Myomectomy was associated with higher complication rates compared to hysterectomy.
Key words: Uterine fibroids, prevalence, presentation, postoperative morbidity.
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