Gyneco obstetrical outcomes after abdominal myomectomy in a Congolese setting population, in the Democratic Republic of the Congo: Devenir gynécologique et obstétrical après myomectomie dans une population congolaise, en République démocratique du Congo

Context and objectives. Although myomectomy is still the most frequent surgery for infertility, data on its impact on pregnancy rate is scarce in Kinshasa, Democratic Republic of Congo (DRC). The present study aimed to describe the clinical profile and the outcome of patients after myomectomy in the context of infertility. Methods. This was a retrospective serial cases study including patients that sought care for infertility and underwent myomectomy at the Kinshasa University Hospital and Edith Medical Center from January 1999 to December 2018. Results. The frequency of myomectomies was 45.47 %. The mean age of the patients was 35.84 ± 5.32 years; the majority (67.5 %) was nulliparous. No significant relationship was noted between the number and weight of myomas with age. After myomectomy, the rate of conception was 16%; primiparous and large multiparas were twice more likely to conceive than nulliparas (OR 2.1385 [CI 95%: 1.2477 - 3.6653] p = 0.006) and (OR 1.5833 [1.232 - 14.467] p = 0.007). Compared to those with one myoma, the removal of 2, 3 and 4 to 10 myomas was associated with 5, 9 and 18 times more chance to conceive (OR 5.1929 [CI 95%: 1.2333 - 21.8652] p = 0.025) (OR 9.2499 [1.900 - 45.0237] p = 0.006) (17.8147 [4.753 - 66.7658] p < 0.0001 respectively. Patients for whom myoma weighed between 501 and 1000 grams were 3 times more likely to conceive (OR 3.1388 [95% CI: 1.8326 - 5.3760] p = 0.000) than those with less than 500 grams. Births at term were perfomed by caesarean section. Conclusion. Myomectomy improves the rate of conception. French Abstract Contexte et objectifs. Bien que la myomectomie soit connue l’intervention la plus pratiquée en infertilité, les données sur son impact sur la conception sont fragmentaires. La présente étude avait pour objectif de décrire le profil clinique des patientes myomateux ayant consulté pour infertilité et le devenir post myomectomie. Méthodes. C’était une étude documentaire d’une série des patientes avec myome ayant subi une myomectomie aux Cliniques universitaires de Kinshasa et au Centre Médical Edith, entre janvier 1999 et décembre 2018. Résultats. La fréquence de myomectomie était de 45,4 %. Leur âge moyen était de 35,8 ± 5,3 ans. Après myomectomie, le taux de conception était de 16 % ; les primipares et les grandes multipares avaient 2 fois plus de chance de concevoir que les nullipares (OR 2,1 [IC 95% : 1,2 – 3,6] p=0,006) et (OR 1,5 [1,2 – 14,4] p=0,007). Comparée à celles qui n’avaient qu’un seul