Clinical and histological determinants of uterine leiomyoma recurrence following myomectomy

Aim: Uterine leiomyomas are frequent benign tumors of the female genital system, and a substantial proportion of them recur following therapy.In this study, the clinical and histological characteristics that influence leiomyoma recurrence in women who have undergone surgical therapy for uterine leiomyoma were evaluated.Material and Methods: Patients who underwent myomectomy for uterine leiomyoma at a tertiary center between 2012 and 2021 were retrospectively analyzed.Demographic characteristics of the patients, clinical results, surgical techniques, and data on leiomyoma recurrence were investigated and evaluated.Recurrence was defined as the appearance of a new leiomyoma that was 1 centimeter or larger in size at transvaginal ultrasonography, which was performed at least 6 months following myomectomy.Results: The study comprised 594 patients with a mean age of 36.3±5.5 (16-53) years and a mean follow-up duration of 23 (6-72) months.Recurrence was detected in 118 (19.9%) of the patients.Estimated recurrence times were found to be 70.5±2.5months, and the 1-year period without recurrence was 96.4%.The number of patients who were reoperated due to recurrence was 48 (8%).It was determined that the recurrence rate was higher in submucosal leiomyomas and lower in subserous leiomyomas (p = 0.002).In addition, cellular myomas were found to have a higher risk of recurrence (p = 0.009).In patients who had pregnancy or delivery after myomectomy, recurrence rates were significantly lower (p = 0.0001).Laparoscopic or laparotomic surgery was not shown to be statistically associated with recurrence (p = 0.326).Discussion: Myoma recurrence risk is influenced by the myoma's location and histological characteristics.The recurrence rate appears to be similar after laparoscopic and laparotomic surgery.Follow-up in terms of recurrence risk may be guided by a careful evaluation of the clinical findings of the patients and an extensive pathological examination.