- Faculty of Medicine, University of Belgrade, Dr Suboti´ca 8, 11000 Belgrade, Serbia; [email protected]
- Clinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, Dr Koste Todorovi´ca 26,
11000 Belgrade, Serbia; [email protected] - Department of Obstetrics and Gynecology, Private Asya Hospital, Yenimahalle mh. 537, St. No.5
Gaziosmanpasa, 34250 Istanbul, Turkey; [email protected] - Department of Interdisciplinary Medicine (DIM), University of Bari, Aldo Moro, 70100 Bari, Italy;
[email protected] (A.M.); [email protected] (M.D.) - Mediliv Medical Center, Kale, Mevlevihane Cd. No.11, 55100 Samsun, Turkey; [email protected]
- Department of Obstetrics and Gynecology, CERICSAL (CEntro di RIcerca Clinico SALentino),
“Veris delli Ponti Hospital”, Via Giuseppina Delli Ponti, 73020 Scorrano, Italy; [email protected]
* Correspondence: [email protected]; Tel.: +381-668-301-332
Abstract: Up to 70–80% of women of reproductive age may be affected with the most common
uterine tumors, known as fibroids or myomas. These benign tumors are the second most prevalent
cause of surgery among premenopausal women. Predictions show that the occurrence of myomas
in pregnancy will increase, and that the risk of having myomas during pregnancy increases with
advanced maternal age. Although most women with fibroids do not experience any symptoms
during pregnancy, up to 30% of women experience problems during pregnancy, childbirth, and the
puerperium. The viability of myoma excision during cesarean surgery (CS) is a contentious issue
raised by the rising incidence of myomas in pregnancy and CS rates. A new surgical procedure for
removing fibroids using a trans-endometrial approach, which involves making an incision through
the decidua itself, has put into doubt the long-standing practice of cesarean myomectomy (CM) with
a trans-serosal approach. Some authors have recently advocated for this last approach, highlighting
its advantages and potential uses in real-world situations. The purpose of this paper is to critique
the present approach to cesarean myomectomy by analyzing the clinical and surgical distinctions
between the two approaches and providing illustrations of the CM methods.
Keywords: cesarean myomectomy; uterine fibroids; uterine myoma; cesarean section; pregnancy;
complications; fertility
