Laparoscopic Intracapsular Myomectomy: Comparison of Single Versus Multiple Fibroids Removal. An Institutional Experience

Objective: The aim of this study was to compare single versus multiple laparoscopic myomectomy with an intracapsular method. Study Design: A total of 335 laparoscopic intracapsular myomectomies were compared. They were subdivided into two groups. Group I included 195 patients with myoma; group II, 140 patients with multiple myomas, 4–9 cm in diameter. Laparoscopic procedures were compared with respect to intraoperative complications, postoperative compliance, and general surgical feedback. Results were analyzed using SAS software (version 8), considering a P-value of <0.05 as significant. Results: No differences (P > 0.05) between groups were observed with respect to the following: intraoperative blood loss (98 ± 4.7 mL of group I versus 106 ± 6.8 mL of group II), catheter inside pelvis for postsurgical drainage (40% versus 36.4% women), analgesic administration for the first 24 hours (41.5% versus 40% patients), postoperative fever after 24 hours (11.2% versus 9.2% women), postoperative therapeutic antibiotics administration (8.2% versus 6.4% patients), and hospitalization and postoperative ultrasound (US) intramyometrial hematoma detection (6.6% versus 5.7% of group II). The only surgical statistical difference (P < 0.05) was in the mean total laparoscopic time (60 ± 7.2 minutes for group I versus 97 ± 8.9 minutes for group II). Conclusions: Intracapsular laparoscopic myomectomies, performed in the same session on a single or on multiple fibroids, seem to preserve myometrial integrity and allow the restoration of uterine scar, with few early and late surgical complications.