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Introduction <p>This retrospective single-center study based on prospectively collected data aimed to evaluate changes in operative performance during the initial experience with vaginal myomectomy.</p> Methods <p>Sixty consecutive patients who underwent VM between January 2021 and December 2023 were included. Demographic features, FIGO-classified myoma characteristics, operative variables, and postoperative outcomes were recorded prospectively. To assess the LC, patients were divided chronologically into four groups of 15 cases. The primary objective was to evaluate changes in operative performance across consecutive cases. Operative time, estimated blood loss, hematocrit decrease, and hospitalization duration were used as measurable indicators of surgical progression, while the occurrence of major complications was assessed as a safety outcome. Groups were compared in terms of preoperative characteristics, intraoperative parameters, and postoperative outcomes.</p> Results <p>The mean age and BMI of the patients were 38.1 years and 28.2&#xa0;kg/m², respectively. Myoma number, diameter, and FIGO-based localization were similar across all groups (<i>p</i> &gt; 0.05). No major intraoperative or postoperative complications occurred. Hematocrit drop and estimated blood loss were significantly higher in the first 15 cases compared to subsequent groups (<i>p</i> = 0.033 and <i>p</i> = 0.005). Operative time significantly decreased after the first 30 cases (<i>p</i> = 0.001), while length of hospital stay significantly shortened after the first 15 cases (<i>p</i> = 0.001). Transfusion rates did not differ between groups (<i>p</i> = 0.923).</p> Conclusion <p>The findings suggest that improvements in bleeding parameters and hospitalization duration became apparent after approximately 15 procedures, whereas operative efficiency improved and appeared to stabilize after approximately 30–34 procedures. These observations should be interpreted within the context of the initial experience of an experienced vaginal surgeon rather than as universally applicable thresholds.</p>

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Outcomes of first 60 vaginal myomectomies by one gyn surgeon with 20 years of extensive vaginal surgical expertise

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月21日

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  • Eda Adeviye Şahin,
  • Turan Şahin,
  • Savaş Özgür Ağlamış,
  • Arzu Bilge Tekin,
  • Hanifi Şahin

摘要

Introduction

This retrospective single-center study based on prospectively collected data aimed to evaluate changes in operative performance during the initial experience with vaginal myomectomy.

Methods

Sixty consecutive patients who underwent VM between January 2021 and December 2023 were included. Demographic features, FIGO-classified myoma characteristics, operative variables, and postoperative outcomes were recorded prospectively. To assess the LC, patients were divided chronologically into four groups of 15 cases. The primary objective was to evaluate changes in operative performance across consecutive cases. Operative time, estimated blood loss, hematocrit decrease, and hospitalization duration were used as measurable indicators of surgical progression, while the occurrence of major complications was assessed as a safety outcome. Groups were compared in terms of preoperative characteristics, intraoperative parameters, and postoperative outcomes.

Results

The mean age and BMI of the patients were 38.1 years and 28.2 kg/m², respectively. Myoma number, diameter, and FIGO-based localization were similar across all groups (p > 0.05). No major intraoperative or postoperative complications occurred. Hematocrit drop and estimated blood loss were significantly higher in the first 15 cases compared to subsequent groups (p = 0.033 and p = 0.005). Operative time significantly decreased after the first 30 cases (p = 0.001), while length of hospital stay significantly shortened after the first 15 cases (p = 0.001). Transfusion rates did not differ between groups (p = 0.923).

Conclusion

The findings suggest that improvements in bleeding parameters and hospitalization duration became apparent after approximately 15 procedures, whereas operative efficiency improved and appeared to stabilize after approximately 30–34 procedures. These observations should be interpreted within the context of the initial experience of an experienced vaginal surgeon rather than as universally applicable thresholds.