Our Summary

This research paper is about a study that compared two types of stitches used during a type of surgery to remove fibroids from the uterus. The study looked at 399 women who had this surgery, using either conventional stitches (nonbarbed suture) or barbed stitches. Of these, 343 women met the criteria for the study and were followed up on. The researchers wanted to see how the type of stitch used affected the women’s ability to get pregnant, the complications during pregnancy, the method of delivery, and any complications from the surgery itself.

The women were split into two groups. Group A (120 women) received the conventional stitches, and Group B (115 women) received the barbed stitches. After surgery, 182 of these women tried to get pregnant. In total, 51.09% of these women became pregnant, with no significant difference between the two groups.

When it came to the results of these pregnancies, the majority (84.9%) resulted in live births, 6.4% ended in miscarriage in the first three months of pregnancy, 2.1% were ectopic pregnancies (where the pregnancy occurs outside the uterus), and 6 were still ongoing at the time of the study. There were no cases of uterine rupture (a serious complication where the uterus tears), and the complications related to pregnancy were similar in both groups.

In conclusion, the study found that using barbed stitches during surgery to remove uterine fibroids is as safe as using conventional stitches and does not affect a woman’s ability to get pregnant or have a healthy pregnancy.

FAQs

  1. Does the type of stitch used in a myomectomy affect a woman’s ability to get pregnant?
  2. Are there any differences in pregnancy complications between women who received conventional stitches and those who received barbed stitches during a myomectomy?
  3. Is there a risk of uterine rupture after a myomectomy using either conventional or barbed stitches?

Doctor’s Tip

A helpful tip a doctor might tell a patient about myomectomy is to discuss with them the type of stitches that will be used during the surgery. This study shows that both conventional and barbed stitches are safe and effective, so the patient can feel reassured about the potential outcomes. It is important for the patient to follow their doctor’s instructions for post-operative care and attend all follow-up appointments to ensure a successful recovery.

Suitable For

Myomectomy is typically recommended for patients who have symptomatic fibroids that are causing severe pain, heavy menstrual bleeding, or fertility issues. Patients who wish to preserve their fertility and have not had success with other treatment options may also be recommended for myomectomy. Additionally, patients who have fibroids that are causing complications such as urinary frequency, constipation, or pelvic pressure may also benefit from myomectomy. It is important for patients to discuss their individual case with their healthcare provider to determine if myomectomy is the best treatment option for them.

Timeline

Before myomectomy:

  1. Patient experiences symptoms of uterine fibroids such as heavy or painful periods, pelvic pain, and pressure on the bladder or rectum.
  2. Patient consults with a doctor and undergoes various tests to diagnose the fibroids.
  3. Doctor recommends myomectomy as a treatment option.
  4. Patient undergoes pre-operative evaluations and preparations for surgery.

After myomectomy:

  1. Patient undergoes surgery to remove the fibroids from the uterus.
  2. Depending on the type of stitches used (conventional or barbed), the patient may experience different outcomes in terms of pregnancy, complications, and method of delivery.
  3. Patient is monitored post-surgery for any complications and to track their ability to get pregnant.
  4. Patient may experience relief from symptoms of fibroids and improved quality of life.

What to Ask Your Doctor

  1. What is a myomectomy and why is it necessary in my case?
  2. What are the potential risks and complications associated with myomectomy surgery?
  3. How will the type of stitches used during my surgery impact my recovery and potential future pregnancies?
  4. Will using barbed stitches instead of conventional stitches affect the success of the surgery or increase the risk of complications?
  5. How soon after my myomectomy can I start trying to conceive, and are there any specific precautions I should take?
  6. Will the type of stitches used during my surgery have any impact on the method of delivery if I become pregnant in the future?
  7. What are the chances of experiencing complications during pregnancy or delivery as a result of the myomectomy surgery?
  8. How long should I wait after my myomectomy before attempting to conceive, and are there any additional factors to consider in terms of fertility and pregnancy following the surgery?
  9. What follow-up care will be necessary after my myomectomy to monitor my reproductive health and any potential complications?
  10. Are there any lifestyle changes or precautions I should take to optimize my chances of a successful pregnancy following myomectomy surgery?

Reference

Authors: Paul PG, Mehta S, Annal A, Chowdary KA, Paul G, Shilotri M. Journal: J Minim Invasive Gynecol. 2022 Jan;29(1):77-84. doi: 10.1016/j.jmig.2021.06.014. Epub 2021 Jun 25. PMID: 34182139