A comparative study on myomectomy and total hysterectomy in the treatment of perimenopausal uterine fibroids

This study aims to compare the clinical efficacy of myomectomy and total hysterectomy in the treatment of perimenopausal uterine fibroids. 124 cases of uterine fibroids were randomly divided into a control group and a study group, each with 62 cases. The control group underwent a total hysterectomy. Study participants underwent a myomectomy. Both groups of patients were observed and compared for surgery-related indicators, quality of life scores, perimenopausal syndrome and inflammatory factors. The study group had a shorter operation time and less intraoperative blood loss (p < 0.05). Before operation, there was no significant difference in Quality of life Short Form 36 (SF-36) score, Interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and IL-10 between both groups (p > 0.05) at 6 months after operation, SF-36 score in both groups were higher than before operation, and IL-6, TNF-α and IL-10 in both groups were higher than before operation (p < 0.05). Perimenopausal syndrome incidence was significantly lower in the study group than in the control group (p < 0.05). Myomectomy is more suitable for treating perimenopausal uterine fibroids.

Myomectomy; Total hysterectomy; Perimenopausal period; Uterine fibroids

[1] Manyonda I, Moss J, Daniels JP. Uterine-Artery Embolization or Myomectomy for Uterine Fibroids. Reply. The New England Journal of Medicine. 2020; 383: 2187.

[2] Boone CE, Kansagra K, Hardley TL. Uterine-artery embolization or myomectomy for uterine fibroids. The New England Journal of Medicine. 2020; 383: 2185.

[3] Slomski A. Relugolix combination therapy for uterine fibroids. JAMA. 2021; 325: 1602.

[4] Erratum to: comprehensive review of uterine fibroids: developmental origin, pathogenesis, and treatment. Endocrine Reviews. 2022; 43: 762.

[5] Corrigendum to: comprehensive review of uterine fibroids: developmental origin, pathogenesis, and treatment. Endocrine reviews 2022; 43: 761.

[6] Yang Q, Ciebiera M, Bariani MV, Ali M, Elkafas H, Boyer TG, et al. Comprehensive review of uterine fibroids: developmental origin, pathogenesis, and treatment. Endocrine Reviews. 2022; 43: 678–719.

[7] Sobel M, Hobson S, Chan C. Uterine fibroids in pregnancy. Canadian Medical Association Journal. 2022; 194: E775.

[8] Saad EE, Michel R, Borahay MA. Immunosuppressive tumor microenvironment and uterine fibroids: role in collagen synthesis. Cytokine & Growth Factor Reviews. 2024; 75: 93–100.

[9] Syed YY. Relugolix/estradiol/norethisterone (norethindrone) acetate: a review in symptomatic uterine fibroids. Drugs. 2022; 82: 1549–1556.

[10] Ali M, Ciebiera M, Wlodarczyk M, Alkhrait S, Maajid E, Yang Q, et al. Current and emerging treatment options for uterine fibroids. Drugs. 2023; 83: 1649–1675.

[11] Islam MS, Afrin S, Singh B, Jayes FL, Brennan JT, Borahay MA, et al. Extracellular matrix and hippo signaling as therapeutic targets of antifibrotic compounds for uterine fibroids. Clinical and Translational Medicine. 2021; 11: e475.

[12] Stewart EA, Lukes AS, Venturella R, Li Y, Hunsche E, Wagman RB, et al. Quality of life with relugolix combination therapy for uterine fibroids: liberty randomized trials. American Journal of Obstetrics and Gynecology. 2023; 228: 320.e1–320.e11.

[13] Stewart EA, Nowak RA. Uterine fibroids: hiding in plain sight. Physiology. 2022; 37: 16–27.

[14] Angkomkamhang US, Lumbiganon P, Pattanittum P. Progestogens or progestogen-releasing intrauterine systems for uterine fibroids (other than preoperative medical therapy). The Cochrane database of systematic reviews. 2020; 11: CD008994.

[15] Paul EN, Grey JA, Carpenter TJ, Madaj ZB, Lau KH, Givan SA, et al. Transcriptome and DNA methylome analyses reveal underlying mechanisms for the racial disparity in uterine fibroids. Journal of Clinical Investigation Insight. 2022; 7: e160274.

[16] Frijlingh M, Juffermans L, de Leeuw R, de Bruyn C, Timmerman D, Van den Bosch T, et al. How to use power doppler ultrasound in transvaginal assessment of uterine fibroids. Ultrasound in Obstetrics and Gynecology. 2022; 60: 277–283.

[17] AlAshqar A, Lulseged B, Mason-Otey A, Liang J, Begum UAM, Afrin S, et al. Oxidative stress and antioxidants in uterine fibroids: pathophysiology and clinical implications. Antioxidants. 2023; 12: 807.

[18] Islam MS, Akhtar MM, Segars JH. Vitamin D deficiency and uterine fibroids: an opportunity for treatment or prevention? Fertility and Sterility. 2021; 115: 1175–1176.