Clin Obstet Gynecol 2009 Sep;52(3):362-71
Department of Obstetrics and Gynecology, Center for Fertility and Women's Health, University of Connecticut School of Medicine, 100 Grand Street, New Britain, CT 06051, USA.
Uterine leiomyomas are common, monoclonal tumors affecting 25% to 45% of reproductive age women. Although frequently asymptomatic, leiomyomas may cause heavy menstrual bleeding, pelvic pressure or pain, and infertility. Myomectomy, which is indicated in symptomatic women who wish to preserve their reproductive function, may be performed by hysteroscopy, laparoscopy, or laparotomy, according to their size, location, number, and the experience of the surgeon. The latter is the most important determinant, as the completeness of the myomectomy and the adequacy of the myometrial closure will determine the subsequent function of the organ in relieving the symptoms and restoring reproductive potential.