The relationship between body mass index and clinical complications among patients undergoing myomectomy

Tuğba Gürbüz; Oğuz Yardımcı; Sertaç Udum; Taner Günay

doi:10.28982/josam.805122

Authors

Tuğba Gürbüz https://orcid.org/0000-0003-3555-3767
Oğuz Yardımcı Medeniyet Univercity Goztepe Training and Research Hospital, Department of Gynecology and Obstetrics, https://orcid.org/0000-0003-0838-8241
Sertaç Udum Medeniyet Univercity Goztepe Training and Research Hospital,Department of Gynecology and Obstetrics, https://orcid.org/0000-0002-6180-0592
Taner Günay Medeniyet Univercity Goztepe Training and Research Hospital, Department of Gynecology and Obstetrics, https://orcid.org/0000-0002-3985-0702

DOI:

https://doi.org/10.28982/josam.805122

Keywords:

Body mass index, Uterine leiomyoma, Abdominal myomectomy, Obesity

Abstract

Aim: Obesity, a chronic disease which significantly causes disability, is a critical public health concern all over the world. A possible correlation between the complications of uterine leiomyoma and obesity has been recently considered, but no definitive conclusions have been made. The purpose of this study is to investigate the association between body mass index (BMI) and clinical complications among the patients undergoing myomectomy to see whether BMI can affect the clinical outcomes and complications of women with uterine leiomyoma. Methods: This retrospective cohort study was conducted on the patients undergoing abdominal myomectomy for uterine leiomyoma from September 2016 to December 2019. A total of 287 patients undergoing abdominal myomectomy participated in the study. The patients were divided into two groups based on BMI: BMI <30 kg/m2 (Group 1) and BMI 30 kg/m2 (Group 2). Results: The mean ages of the patients in Groups 1 and 2 were 37.08(6.17) years and 37.53 (5.98) years, respectively. Among all, 196 patients had a BMI of <30 kg/m2 and 91 patients had a BMI of 30 kg/m2. There was no statistically significant difference between the two groups in terms of surgical indication (P=0.970), leiomyoma localization (P=0.793), leiomyoma size (P=0.335), the mean number of fibroids removed (P=0.537), postoperative pathological diagnosis (P=0.189), complications, and the mean duration of hospital stay (P=0.249). There was a statistically significant difference between the two groups in terms of BMI (P<0.001), ALT (P=0.039), and Urea (P=0.018). Conclusion: BMI did not adversely affect the clinical outcomes of patients undergoing abdominal myomectomy. Obesity is not regarded as a risk factor for poor outcomes.

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References

Stewart EA. Uterine fibroids. Lancet. 2001;357(9252):293-8.

Sankaran S, Manyonda IT. Medical management of fibroids. Best Pract Res Clin Obstet Gynaecol. 2008;22(4):655-76.

Parker WH. Etiology, symptomatology, and diagnosis of uterine myomas. Fertil Steril. 2007;87(4):725-36.

Sunkara SK, Khairy M, El-Toukhy T, Khalaf Y, Coomarasamy A. The effect of intramural fibroids without uterine cavity involvement on the outcome of IVF treatment: a systematic review and meta-analysis. Hum Reprod. 2010;25(2):418-29.

Matchar DB, Myers ER, Barber MW, Couchman GM, Datta S, Gray RN, et al. Management of uterine fibroids. Evid Rep Technol Assess (Summ). 2001;(34):1-6.

Ilaria S, Marci R. From obesity to uterine fibroids: an intricate network. Curr Med Res Opin. 2018;34(11):1877-79.

Shikora SA, Niloff JM, Bistrian BR, Forse RA, Blackburn GL. Relationship between obesity and uterine leiomyomata. Nutrition. 1991;7(4):251-5.

Camanni M, Bonino L, Delpiano EM, Migliaretti G, Berchialla P, Deltetto F. Laparoscopy and body mass index: feasibility and outcome in obese patients treated for gynecologic diseases. J Minim Invasive Gynecol. 2010;17(5):576-82.

Dandolu V, Singh R, Lidicker J, Harmanli O. BMI and uterine size: is there any relationship?. Int J Gynecol Pathol. 2010;29(6):568-71.

Okolo S. Incidence, aetiology and epidemiology of uterine fibroids. Best Pract Res Clin Obstet Gynaecol. 2008;22(4):571-88.

Flake GP, Andersen J, Dixon D. Etiology and pathogenesis of uterine leiomyomas: a review. Environ Health Perspect. 2003;111(8):1037-54.

Çinar M, Tokmak A, Güzel AI, Aksoy RT, Özer İ, Yilmaz N, et al. Association of clinical outcomes and complications with obesity in patients who have undergone abdominal myomectomy. J Chin Med Assoc. 2016;79(8):435-9.

Wen KC, Horng HC, Wang PH. Hemorrhage: A strong indicator for myomectomy-related complication. J Chin Med Assoc. 2016;79(8):413-4.

Dorgan JF, Reichman ME, Judd JT, Brown C, Longcope C, Schatzkin A, et al. The relation of body size to plasma levels of estrogens and androgens in premenopausal women. Cancer Causes Control. 1995;6(1):3-8.

Verkasalo PK, Thomas HV, Appleby PN, Davey GK, Key TJ. Circulating levels of sex hormones and their relation to risk factors for breast cancer: a cross-sectional study in 1092 pre- and postmenopausal women (United Kingdom). Cancer Causes Control: CCC. 2001;12(1):47-59.

He Y, Zeng Q, Dong S, Qin L, Li G, Wang P. Associations between uterine fibroids and lifestyles including diet, physical activity and stress: a case-control study in China. Asia Pac J Clin Nutr. 2013;22(1):109-17.

Burke GL, Jacobs Jr, Sprafka JM, Savage PJ, Sidney S, Wagenknecht LE. Obesity and overweight in young adults: The CARDIA study. Prev Med. 1990 Jul;19(4):476-88.

Smith DE, Lewis CE, Caveny JL, Perkins LL, Burke GL, Bild DE. Longitudinal changes in adiposity associated with pregnancy. The CARDIA Study. Coronary Artery Risk Development in Young Adults Study. JAMA. 1994;271(22):1747-51.

Harmanli O, Esin S, Knee A, Jones K, Ayaz R, Tunitsky E. Effect of obesity on perioperative outcomes of laparoscopic hysterectomy. J Reprod Med. 2013;58(11-12):497-503.

Osler M, Daugbjerg S, Frederiksen BL, Ottesen B. Body mass and risk of complications after hysterectomy on benign indications. Hum Reprod. 2011;26(6):1512-8.

Duchesne JC, Schmieg RE Jr, Simmons JD, Islam T, McGinness CL, McSwain NE Jr. Impact of obesity in damage control laparotomy patients. J Trauma. 2009;67(1):108-12;112-4.

Çoşkun B, Güzel A, Çoşkun B, Kokanalı D, Şi̇mşi̇r C, Doğanay M . The evaluation of association between body mass index and clinical parameters in women underwent myomectomy. J Health Sci Med / JHSM. 2020;3(1):47-50.

Amruta C, Shetty A, Pawaskar N, Desai S. Association between uterine leiomyoma with body mass index and parity in the women of coastal Karnataka, India. Int J Reprod Contracept Obstet Gynecol. 2020;9(2):740-3.

Parazzini F, Negri E, La Vecchia C, Chatenoud L, Ricci E, Guarnerio P. Reproductive factors and risk of uterine fibroids. Epidemiology. 1996;7(4):440-2.

Wise LA, Palmer JR, Spiegelman D, Harlow BL, Stewart EA, Adams-Campbell LL, et al. Influence of body size and body fat distribution on risk of uterine leiomyomata in U.S. black women. Epidemiology. 2005;16(3):346-54.

Siedhoff MT, Carey ET, Findley AD, Riggins LE, Garrett JM, Steege JF. Effect of extreme obesity on outcomes in laparoscopic hysterectomy. J Minim Invasive Gynecol. 2012;19(6):701-7.

Lamvu G, Zolnoun D, Boggess J, Steege JF. Obesity: physiologic changes and challenges during laparoscopy. Am J Obstet Gynecol. 2004;191(2):669-74.

George A, Eisenstein D, Wegienka G. Analysis of the impact of body mass index on the surgical outcomes after robot-assisted laparoscopic myomectomy. J Minim Invasive Gynecol. 2009;16(6):730-3.

Nawfal AK, Orady M, Eisenstein D, Wegienka G. Effect of body mass index on robotic-assisted total laparoscopic hysterectomy. J Minim Invasive Gynecol. 2011;18(3):328-32.

Sparic R, Mirkovic L, Malvasi A, Tinelli A. Epidemiology of Uterine Myomas: A Review. Int J Fertil Steril. 2016;9(4):424-35.