Caesarean myomectomy: TE or not TE?

Abstract

Over the last 5 years there has been a plethora of studies looking at the complications and feasibility of performing myomectomy at the time of caesarean section (Li et al. Acta Obstet Gynecol Scand 2009;88:183–6; Akkurt et al. J Matern-Fetal Neonatal Med 2017;30:1855–60). Few if any of these studies have come from the UK or the USA, and while the commandment ‘thou should never touch a fibroid at a caesarean section’ seems to have originated in the developed world, the rules are being questioned elsewhere, with results that universally show, despite the expected increase in operating time, no significant increase in morbidity besides an increase need for blood transfusion and, most importantly, no excess of hysterectomy being required.