To review important considerations in the counseling and management of women over the age of 40 desiring a myomectomy for symptomatic fibroids.
Women in the late reproductive and perimenopausal years may choose a myomectomy over a hysterectomy for reasons of fertility preservation or a personal desire to retain their uterus. Data suggest that laparoscopic myomectomy is a low-risk procedure that can be offered to older women, though the age-related risk of uterine malignancy must be evaluated.
When assessing the surgical candidacy of older women desiring myomectomy, it is important to weigh a woman's fertility potential, surgical risk, and concerns about malignancy with her desire to preserve the uterus and autonomy to choose a procedure type.
aDepartment of Obstetrics and Gynecology, Brigham and Women's Hospital
bDivision of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts, USA
Correspondence to Nisse V. Clark, MD, MPH, Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Massachusetts General Hospital, 55 Fruit Street, Founders 4, Boston, MA 02114, USA. Tel: +1 617 724 3775; e-mail: firstname.lastname@example.org