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| Analysis of the risk factors of the intrauterine adhesion after myomectomy and the predicting of these risk factors for the intrauterine adhesion |
| Zhejiang Jinhua Guangfu Tumor Hospital, Jinhua, Zhejiang Province, 321000 |
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Abstract To investigate the risk factors of intrauterine adhesion after myomectomy. Methods: The clinical data of 152 patients with myomectomy from June 2020 to June 2022 were collected, and the incidence of the postoperative intrauterine adhesion of these patients was observed. Univariate and multivariate Logistic regression analysis were used to explore the influencing factors of the intrauterine adhesion after myomectomy. Receiver operator characteristic (ROC) curve was drawn to observe the predictive value of the combination of the independent risk factors of the patients for their postoperative intrauterine adhesion. Results: Among the 152 patients, 27 (17.8%) cases had intrauterine adhesions, including 5 cases with severe adhesions, 8 cases with moderate adhesions, and 14 cases with mild adhesions. Univariate analysis showed that the previous history of uterine surgery, the maximum fibroid diameter, the maximum fibroid type, the surgical approach, and the incision of uterine cavity of the patients were correlated with their intrauterine adhesion after myomectomy (P＜0.05). Multivariate analysis showed that the history of uterine surgery, the surgical approach with laparotomy, and the incision of uterine cavity of the patients were the independent risk factors of their uterine adhesions after myomectomy (P＜0.05). ROC curve showed that the area under the curve of the combination of the previous history of uterine surgery, the surgical approach with laparotomy, and the incision of uterine cavity of the patients for predicting their postoperative uterine adhesion was 0.696 (P=0.001, 95%CI 0.587-0.804). Conclusion: The patients with the previous history of uterine surgery, with the surgical approach with laparotomy, or with the incision of uterine cavity have higher risk of intrauterine adhesion after myomectomy, which should be paid more attention to in clinical practice.
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