European Journal of Biomedical and Pharmaceutical Sciences

POSTOPERATIVE OUTCOMES FOLLOWING MYOMECTOMY: A RETROSPECTIVE COMPARISON BASED ON FIBROID SIZE

Majida EL-Sukkar*, Baghdad Shannag, Baidaa Baninaser, Bara’ah Alna’san, Areej Alshaar, Moh’d Obeidat, Wisam AL-Sukkar

ABSTRACT

Background: Uterine fibroids are common benign tumors among reproductive-age women. Myomectomy is a fertility-sparing option for symptomatic cases. However, the impact of fibroid size on intraoperative and postoperative complications remains a subject of clinical concern. Objective: To evaluate postoperative outcomes in women undergoing myomectomy for fibroids ≤5 cm versus >5 cm. Methods: A retrospective chart review was conducted for patients who underwent abdominal or laparoscopic myomectomy between 2019 and 2023 at King Hussein Medical Center, Amman, Jordan. Patients were grouped by dominant fibroid size. Data included operative time, estimated blood loss, need for transfusion, post-operative infection, and hospital stay. Statistical analysis was performed using R (version 4.4.2), with p < 0.05 considered significant. Results: In this cohort of 720 patients, fibroids >5 cm were linked to more invasive surgery, with 59% undergoing open procedures versus 32% for smaller fibroids. Larger fibroids also led to longer operative times (165 vs. 126 minutes), higher blood loss (303 vs. 140 mL), longer hospital stays (3.45 vs. 2.20 days) and increased 30-day surgical-site infections (7.0% vs. 2.7%). Transfusion rates were slightly higher with larger fibroids (10% vs. 6.3%) but fibroid size was not an independent predictor. Open surgery and diabetes significantly increased transfusion risk. These findings highlight that fibroid size drives surgical complexity and morbidity, while transfusion risk is influenced mainly by surgical approach and comorbidities. Conclusion: Larger fibroid size was linked to more invasive surgical approaches, higher blood loss, longer operative time, extended hospitalization, and increased infection risk. However, fibroid size did not independently predict transfusion, which was more strongly associated with surgical route and diabetes. Careful preoperative planning and minimally invasive approaches where feasible may reduce morbidity in myomectomy patients.

Keywords: Uterine Fibroids, Myomectomy, Surgical Complications, Fibroid Size, Retrospective Study.