Quality of Life After Laparoscopic and Open Abdominal Myomectomy

Abstract OBJECTIVE To evaluate baseline and post-operative changes in quality-of-life and symptom-severity scores in women undergoing laparoscopic or open abdominal myomectomy for symptomatic fibroids. DESIGN Prospective cohort study of patients choosing myomectomy for symptomatic uterine fibroids. SETTING Academic medical center PATIENTS A total of 143 women enrolled in the study. Eighty women completed both a pre-operative questionnaire and at least one post-operative questionnaire between 6- and 27-months following surgery. INTERVENTIONS 52 women had an open abdominal myomectomy and 28 had a laparoscopic myomectomy between October 2014 and September 2017. MEASUREMENTS The results of the Uterine Fibroid Symptom and Health-Related Quality of Life Questionnaire (UFS-QOL) were compared before and after laparoscopic or open myomectomy. MAIN RESULTS Women undergoing open abdominal myomectomy had larger and more numerous fibroids than women undergoing laparoscopic myomectomy. Baseline quality-of-life scores were less adversely affected for women having laparoscopic myomectomy (mean 57 (SD 24) laparoscopic v 43 (SD 19) open abdominal, p=0.01). However, baseline symptom-severity scores were statistically similar (49 (SD 22) for laparoscopic and 57 (SD 20) for open abdominal, p=0.08). Six to twelve months following surgery, both open abdominal and laparoscopic surgery provided excellent and similar improvements in symptom-severity and quality-of-life (post-operative symptoms severity scores, mean 20 (SD 14) laparoscopic v 13 (SD 11) open abdominal, p=0.24, and quality-of-life scores (mean = 91 (SD 16) laparoscopic v 88 (SD 17) open abdominal, p=0.49). These improvements were sustained for women who returned questionnaires up to 27-months of follow-up. CONCLUSION Women with symptomatic fibroids have compromised quality-of-life and they experience a similarly dramatic improvement in quality-of-life and decrease in symptom severity following both laparoscopic and open abdominal myomectomy.