Fertility and Patient Satisfaction After Robotic-Assisted Laparoscopic Myomectomy
Bibliographic record
Abstract
INTRODUCTION: Uterine fibroids in premenopausal women may be associated with abnormal uterine bleeding, pain, infertility, and pregnancy loss. The objective of this study is to evaluate fertility outcomes, symptom relief, and cosmetic satisfaction in patients who underwent robotic-assisted laparoscopic myomectomy in Canada. METHODS: A prospective qualitative assessment of women who underwent robotic-assisted laparoscopic myomectomy at St. Michael's Hospital between October 2008 and September 2013 was completed with Research Ethics Board approval. Through telephone interviews, participants were asked about pregnancy outcomes, postsurgical symptoms, and cosmetic satisfaction. These results as well as uterine fibroid characteristics were analyzed. RESULTS: Of 77 women who underwent robotic-assisted laparoscopic myomectomy from October 2008 to September 2013, 63 agreed to participate (mean age 38 years). After robotic-assisted laparoscopic myomectomy, 34 women (54%) attempted to conceive (for 1 month or more). Of those attempting to conceive, 21 (21/34 [62%]) became pregnant and eight (8/34 [24%]) were unable to conceive after 6 or more months. Sixteen women (16/34 [47%]) had successfully delivered or were more than 24 weeks pregnant at the time of writing. Seven (7/34 [21%]) women experienced at least one miscarriage. All women who delivered after robotic-assisted laparoscopic myomectomy had a cesarean delivery. Forty-four women (44/63 [70%]) were “satisfied” or “extremely satisfied” with the cosmetic appearance of their scar. Those unsatisfied all had hypertrophic scarring. Fifty-six women (56/63 [89%]) were asymptomatic after their robotic-assisted laparoscopic myomectomy. Uterine fibroids recurred in 24 women (24/63 [38%]) at the time of data collection, all diagnosed by radiologic imaging. The majority of these were asymptomatic. CONCLUSION: Robotic-assisted laparoscopic myomectomy offers a minimally invasive option for myomectomy, following which fertility and reproductive success are comparable with figures in the general population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".