Comparison of fertility outcomes after laparoscopic myomectomy for barbed versus nonbarbed sutures.

Abstract:

OBJECTIVE:To assess the impact on women's reproductive outcomes of barbed sutures to repair uterine breaches during laparoscopic myomectomy compared with traditional smooth sutures. DESIGN:Retrospective, monocentric cohort study, with information on subsequent pregnancies prospectively acquired for some women. SETTING:Tertiary-level academic referral center. PATIENT(S):Women older than 18 years who had undergone a laparoscopic myomectomy and had sought pregnancy afterward, divided into two groups based on type of suture used to repair the uterine wall: group A (nonbarbed) and group B (barbed). INTERVENTION(S):Laparoscopic removal of FIGO types 3, 4, 5, and 6 uterine leiomyomas by use of either only barbed sutures or only traditional smooth sutures to reconstruct the uterine defect. MAIN OUTCOME MEASURE(S):Pregnancy achievement rates, delivery modes, main pregnancy complications, perioperative complications for both kinds of suture, and the trend of the use of barbed sutures over time at our center. RESULT(S):Of 164 patients included, 83 were in group A and 81 in group B. Ninety-one patients (55.5%) experienced at least one postoperative pregnancy, with no differences between the groups (group A 60.5%; group B 50.6%). Of the 103 recorded postoperative pregnancies, 70 (68%) resulted in live births, 29 (28.1%) in first-trimester miscarriages, and 4 (3.9%) were ongoing. CONCLUSION(S):Barbed sutures have a similar impact on reproductive outcomes as smooth conventional threads, both in terms of pregnancy and obstetric complication rates, after laparoscopic myomectomy.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Arena A,Degli Esposti E,Cristani G,Orsini B,Moro E,Raimondo D,Del Forno S,Lenzi J,Casadio P,Seracchioli R

doi

10.1016/j.fertnstert.2020.07.036

subject

Has Abstract

pub_date

2021-01-01 00:00:00

pages

248-255

issue

1

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(20)30689-0

journal_volume

115

pub_type

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