Important considerations for women in the late reproductive and perimenopausal years desiring myomectomy.

Overview

PURPOSE OF REVIEW: To review important considerations in the counseling and management of women over the age of 40 desiring a myomectomy for symptomatic fibroids. RECENT FINDINGS: 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. SUMMARY: 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.