Fertility and Symptom Relief following Robot-Assisted Laparoscopic Myomectomy

Obstetrics and Gynecology International - Tập 2015 - Trang 1-9 - 2015
Michael C. Pitter1, Serene S. Srouji2, Antonio R. Gargiulo2, Leslie Kardos3, Usha Seshadri‐Kreaden4, Helen B. Hubert5, Glenn A. Weitzman6
1Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY 10032, USA
2Department of Obstetrics and Gynecology, Center for Infertility and Reproductive Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
3Department of Obstetrics and Gynecology, California Pacific Medical Center, 475 Brannan Street, San Francisco, CA 94107, USA
4Department of Clinical Affairs, Intuitive Surgical Inc., 1266 Kifer Road, Building 101, Sunnyvale, CA 94086, USA.
5Stanford University School of Medicine Emerita, 1043 Oakland Avenue, Menlo Park, CA 94025, USA.
6Nashville Fertility Center, 345 23rd Avenue, Nashville, TN 37203, USA.

Tóm tắt

Objective. To examine success of robot-assisted laparoscopic myomectomy (RALM) measured by sustained symptom relief and fertility.Methods. This is a retrospective survey of 426 women who underwent RALM for fibroids, symptom relief, or infertility at three practice sites across the US. We examined rates of symptom recurrence and pregnancy and factors associated with these outcomes.Results. Overall, 70% of women reported being symptom-free, with 62.9% free of symptoms after three years. At >3 years, 66.7% of women who underwent surgery to treat infertility and 80% who were also symptom-free reported achieving pregnancy. Factors independently associated with symptom recurrence included greater time after surgery, preoperative dyspareunia, multiple fibroid surgeries, smoking after surgery, and preexisting diabetes. Factors positively correlated with achieving pregnancy included desiring pregnancy, prior pregnancy, greater time since surgery, and Caucasian race. Factors negatively correlated with pregnancy were advanced age and symptom recurrence.Conclusions. This paper, the first to examine symptom recurrence after RALM, demonstrates both short- and long-term effectiveness in providing symptom relief. Furthermore, RALM may have the potential to improve the chance of conception, even in a population at high risk of subfertility, with greater benefits among those who remain symptom-free. These findings require prospective validation.

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Tài liệu tham khảo

10.1016/j.fertnstert.2007.01.093

10.1097/gco.0b013e3283612188

10.1016/j.jmig.2014.08.007

2009, European Journal of Obstetrics & Gynecology and Reproductive Biology, 145, 14, 10.1016/j.ejogrb.2009.03.009

10.1097/gco.0b013e328348a245

10.1016/j.jmig.2012.12.010

10.3109/09513590.2012.705393

10.1111/j.1600-0412.2011.01207.x

10.1007/s11701-012-0354-3

10.1093/humrep/des365

10.1016/j.fertnstert.2014.07.1220

10.1016/j.ejogrb.2014.05.029

10.1016/s1074-3804(05)60610-x

10.1016/s1074-3804(98)80025-x

10.1016/j.jmig.2007.06.003

10.1093/aje/153.1.1

10.1016/j.bpobgyn.2008.04.002

10.1136/bmj.293.6543.359

10.1016/j.fertnstert.2008.08.074

10.1097/ede.0b013e31819d8d3f

10.1016/j.fertnstert.2006.11.012

10.1093/molehr/gah199

10.1038/nrd2359

10.1016/s0301-2115(03)00159-3

10.1016/j.jmig.2005.03.011

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Obstetrics and Gynecology International

Tập 2015

1-9

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