A comparison of satisfaction for patients undergoing abdominal or laparoscopic myomectomy: a prospective study

OBJECTIVE: The primary purpose of this study is to compare patients’ satisfaction after laparoscopic myomectomy versus abdominal myomectomy for treatment of symptomatic uterine leiomyomas. Additionally, objective post-operative outcomes such as post-operative pain, hospitalization length, time until return to work will be compared between the two groups. DESIGN: Prospective, non-randomized cohort study in a community teaching hospital. MATERIALS AND METHODS: All patients undergoing either laparoscopic or abdominal myomectomy who meet study criteria were invited to complete surveys to evaluate the post-operative experience and satisfaction at 3 months, and at 6 months after the surgery. The type of surgery (abdominal or laparoscopic myomectomy) was determined by the attending physician. RESULTS: Patient satisfaction was high in both groups. As expected, blood loss and length of stay was significantly lower in the laparoscopic group. The abdominal myomectomy patients had significantly more fibroids and a higher BMI, but the total hospital charges were lower in this group. There was a trend to earlier “full recovery” for laparoscopy patients. The BMI, number of fibroids, and percentage having abdominal myomectomies were higher in African-American women. The uterine fibroid symptom and quality of life scores at baseline and 6 months were not different between the groups.Table 1Laparoscopic and Abdominal MyomectomyAbdominal Mean (SD) N=30Laparoscopic Mean (SD) N=17P-valueAge (years)36.0 (3.7)37.0 (3.9)0.388BMI28.3 (6.7)24.3 (3.5)0.046Number Fibroids3.9 (1.4)2.6 (1.7)0.001Intraoperative Blood Loss (cc)266.3 (221.6)107.5 (118.8)0.0052-Hour Pain Intensity (1-10)3.6 (2.0)4.1 (2.7)0.486Hospital Stay (days)2.5 (1.0)1.2 (0.8)<0.0001Total Charges ($)13,251 (2,400)16,256 (2,072)<0.0001Satisfaction Scale (1-10)8.6 (1.6)8.5 (1.7)0.850% Normal Activity (6 months)97.0 (8.4)96.9 (7.5)0.746Days Until Full Activity33.4 (21.1)22.1 (18.7)0.105No. Days Narcotics Used8.7 (9.2)6.3 (5.9)0.781 Open table in a new tab CONCLUSIONS: Outcomes were uniformly good in this study, and all patients recorded a high level of satisfaction with their procedure and improvement in their quality of life, with no difference noted between abdominal and laparoscopic surgery. Either approach is appropriate for women with symptomatic uterine fibroids.