Uterine Leiomyomata in South Western Nigeria: A clinical study of presentations and management outcome

FO Okogbo, OC Ezechi, OM Loto, PM Ezeobi

Abstract

Background: Uterine leiomyoma is remarkably common, however only a subset of women have their fibroids clinically detected, symptomatic, or warrant surgical treatment. Its removal is commonly associated with complications. To prevent or control the occurrence of this complication requires the understanding of the factors associated with the complications.

Objective: To evaluate the sociodemographic, clinical characteristics, management outcome and its determinants in southwestern Nigeria.

Methods: Study was carried out at two large tertiary hospitals in the south west region of Nigeria. Retrospective review of case records of all surgically managed cases of uterine leiomyoma over a period of 25 years. One
hundred and fifty nine women with uterine leiomyoma seen and managed surgically in South-Western Nigeria were the participants.

Results: The common presenting complaints were menstrual irregularities (47.7%), abdominal swelling (39.1%) and infertility (31.9%). The average uterine size at presentation was 15±9.7 weeks. The majority (79.9%) of the women presented with multiple leiomyomata. The commonest anatomical position of the nodules were multiple positions and intramural in 707(60.9%) and 172(14.8%) respectively. Myomectomy was performed in 54.7% of cases. Postoperative complications occurred in 20.9 % of cases with postoperative pyrexia (13.5%), blood loss warranting transfusion (12.8%) and postoperative anaemia (10.4%) been the most common complications.

Conclusion: Uterine fibroid is common in our environment and its removal is commonly associated with post-operative pyrexia, blood loss, and anaemia and wound infection. Midline incision, closure of rectus sheet with chromic catgut and myomectomy were associated with postoperative complications in this review.