Treating symptomatic uterine fibroids with myomectomy: current practice and views of UK consultants.

Rebecca Mallick, Funlayo Odejinmi
Gynecological Surgery · 2017 · doi:10.1186/s10397-017-1033-1 · PMID:29285023 · PMC5736775
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This letter to the editor discusses UK consultants' views on myomectomy for symptomatic uterine fibroids, highlighting concerns about hysteroscopic resection limits, complete fibroid removal rates, and access to laparoscopic myomectomy and uterine artery embolization.

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This letter critiques a survey on UK consultants' practices regarding myomectomy for symptomatic uterine fibroids, highlighting issues such as low response rates and recall bias. The authors note that while the number of surgeons performing these procedures has increased, significant disparities exist in access to modalities like laparoscopic myomectomy and uterine artery embolisation. They argue that experienced surgeons should perform complex cases and that perimenopausal women should be offered uterine-sparing options with adequate counselling. Relevance to endometriosis: the paper explicitly references endometriosis by suggesting that specialized tertiary referral centres for fibroid management could adopt a holistic multidisciplinary approach similar to that currently available through BSGE-badged endometriosis centres.

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Acknowledgements

Nothing to declare. Funding Not applicable. Availability of data and materials Not applicable. Authors’ contributions RM and FO both participated in the manuscript writing, and both authors approved the final manuscript. Authors’ information Nothing to declare. * Correspondence: [email protected] Department of Gynaecology, Barts Health NHS Trust, Whipps Cross University Hospital, London E11 1NR, UK Gynecological Surgery © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Mallick and Odejinmi Gynecological Surgery (2017) 14:28 DOI 10.1186/s10397-017-1033-1 Ethics approval and consent to participate Not required. Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. Publisher’sN o t e Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Received: 17 July 2017 Accepted: 10 December 2017 /

References

1. Sirkeci RF, Belli AM, Manyonda IT (2017) Treating symptomatic uterine fibroids with myomectomy: current practice and views of UK consultants. Gynecol Surg 14(1):11 2. Wang CJ, HT Y, PJ W, Su H, KY W, Han CM (2013) Laparoscopic myomectomy instead of hysteroscopic myomectomy for large submucous fibroids. Gynecol Minim Invasive Ther 2(3):93– 95 3. Frederick J, Hardie M, Reid M, Fletcher H, Wynter S, Frederick C (2002) Operative morbidity and reproductive outcome in secondary myomectomy: a prospective cohort study. Hum Reprod 17(11):2967 –2971 4. Odejinmi F, Maclaran K, Agarwal N (2015) Laparoscopic treatment of uterine fibroids: a comparison of peri-operative outcomes in laparoscopic hysterectomy and myomectomy. Arch Gynecol Obstet 291(3):579 –584 Mallick and Odejinmi Gynecological Surgery (2017) 14:28 Page 2 of 2

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