Comparison of Intraoperative and Postoperative Outcomes of Laparoscopic and Open Myomectomy in Women With Uterine Fibroids: A Retrospective Study at a Tertiary Care Hospital in Central India

Background Myomectomy is a uterus-preserving surgery for women with symptomatic uterine fibroids desiring fertility. Comparing laparoscopic myomectomy (LM) and open myomectomy (OM) can help guide optimal surgical decisions. This study aimed (1) to compare intraoperative and postoperative outcomes between LM and OM, and (2) to identify clinical predictors influencing the choice of surgical approach in women with symptomatic uterine fibroids. Methodology This prospective, comparative, non-randomized study included 80 women with symptomatic fibroids, consecutively sampled and allocated into LM (n = 40) and OM (n = 40) groups based on fibroid size, number, and surgeon decision. Outcomes included intraoperative blood loss, operative time, pain scores (Numeric Rating Scale (NRS)), hospital stay, and time to resume normal activities. Data were analyzed using t-tests, linear and logistic regression, and repeated measures analysis of variance. Surgeons performing LM and OM had comparable experience, and outcome assessors were blinded to surgical groups. Results Mean fibroid size was significantly larger in the OM group (7.61 ± 1.32 cm) than in the LM group (4.81 ± 1.10 cm; p < 0.001). OM had greater intraoperative blood loss (278.25 ± 57.87 mL vs. 112.38 ± 33.29 mL; p < 0.001) and higher postoperative pain scores (6.70 ± 0.82 vs. 2.42 ± 0.93; p < 0.001), but shorter operative time (98.03 ± 15.67 vs. 133.47 ± 15.96 minutes; p < 0.001). LM patients had shorter hospital stays (2.08 ± 0.47 vs. 5.30 ± 1.27 days; p < 0.001) and resumed normal activities earlier (8.38 ± 2.26 vs. 16.10 ± 4.02 days; p < 0.001). Missing data were minimal (<2%) and handled using listwise deletion. All measurement instruments (e.g., NRS) were validated tools with cited references. Conclusions LM provides superior short-term outcomes, namely, less pain, lower blood loss, and shorter recovery, despite longer operative time. Surgical planning should consider fibroid size, surgeon expertise, and patient preference. Further prospective studies are needed for long-term outcome assessment.