Fertility and Symptom Relief following Robot-Assisted Laparoscopic Myomectomy
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 r...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Obstetrics and Gynecology International |
| Online Access: | http://dx.doi.org/10.1155/2015/967568 |
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| author | Michael C. Pitter Serene S. Srouji Antonio R. Gargiulo Leslie Kardos Usha Seshadri-Kreaden Helen B. Hubert Glenn A. Weitzman |
| author_facet | Michael C. Pitter Serene S. Srouji Antonio R. Gargiulo Leslie Kardos Usha Seshadri-Kreaden Helen B. Hubert Glenn A. Weitzman |
| author_sort | Michael C. Pitter |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-4f9d10a06b7c4723aa10e4507e30a7b3 |
| institution | Kabale University |
| issn | 1687-9589 1687-9597 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Obstetrics and Gynecology International |
| spelling | doaj-art-4f9d10a06b7c4723aa10e4507e30a7b32025-02-03T01:11:33ZengWileyObstetrics and Gynecology International1687-95891687-95972015-01-01201510.1155/2015/967568967568Fertility and Symptom Relief following Robot-Assisted Laparoscopic MyomectomyMichael C. Pitter0Serene S. Srouji1Antonio R. Gargiulo2Leslie Kardos3Usha Seshadri-Kreaden4Helen B. Hubert5Glenn A. Weitzman6Department of Obstetrics & Gynecology, Columbia University Medical Center, New York, NY 10032, USADepartment of Obstetrics and Gynecology, Center for Infertility and Reproductive Surgery, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USADepartment of Obstetrics and Gynecology, Center for Infertility and Reproductive Surgery, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USADepartment of Obstetrics and Gynecology, California Pacific Medical Center, 475 Brannan Street, San Francisco, CA 94107, USADepartment of Clinical Affairs, Intuitive Surgical Inc., 1266 Kifer Road, Building 101, Sunnyvale, CA 94086, USAStanford University School of Medicine Emerita, 1043 Oakland Avenue, Menlo Park, CA 94025, USANashville Fertility Center, 345 23rd Avenue, Nashville, TN 37203, USAObjective. 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.http://dx.doi.org/10.1155/2015/967568 |
| spellingShingle | Michael C. Pitter Serene S. Srouji Antonio R. Gargiulo Leslie Kardos Usha Seshadri-Kreaden Helen B. Hubert Glenn A. Weitzman Fertility and Symptom Relief following Robot-Assisted Laparoscopic Myomectomy Obstetrics and Gynecology International |
| title | Fertility and Symptom Relief following Robot-Assisted Laparoscopic Myomectomy |
| title_full | Fertility and Symptom Relief following Robot-Assisted Laparoscopic Myomectomy |
| title_fullStr | Fertility and Symptom Relief following Robot-Assisted Laparoscopic Myomectomy |
| title_full_unstemmed | Fertility and Symptom Relief following Robot-Assisted Laparoscopic Myomectomy |
| title_short | Fertility and Symptom Relief following Robot-Assisted Laparoscopic Myomectomy |
| title_sort | fertility and symptom relief following robot assisted laparoscopic myomectomy |
| url | http://dx.doi.org/10.1155/2015/967568 |
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