Leiomyoma characteristics and risk of subsequent surgery after myomectomy

Objective: Evaluate the association between leiomyoma characteristics at myomectomy with subsequent surgery risk. Methods: A population-based nested case control study from a cohort of women at a large HMO, identified as having had a myomectomy was performed; 82 cases had subsequent uterine surgery; 82 controls, frequency matched for age and date of first surgery, did not. Medical records were abstracted; follow-up was 18–128 months. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated. Results: Women without subserosal myomas were more likely to have a second surgery as compared to women with at least one subserosal myoma, aOR = 4.1(95% CI 1.5–10.9). Size of myomas did not predict subsequent surgery in subanalyses by type of surgery. Number of leiomyomas was not predictive of a subsequent uterine surgery overall or in subgroup analyses. Conclusion: Myoma location, but not number or size, impacts the risk for subsequent leiomyoma uterine surgery.