DOES SURGICAL APPROACH MATTER? RISK OF UTERINE RUPTURE AFTER LAPAROSCOPIC VERSUS OPEN MYOMECTOMY – A CONTEMPORARY REVIEW

Milena B. Polak; N. Sara Kuśmierowska; Monika Kuś; Grzegorz Słomkowski; Tymoteusz Białowąs; Dominika Karolak; Magdalena N. Nowak; Konrad Wiśniewski; Daria Valipur Kolti; Kacper Cholewiński; Agnieszka E. Kierska

doi:10.31435/ijitss.2(50).2026.5690

Authors

Milena B. Polak Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0007-6148-5354
N. Sara Kuśmierowska Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0006-7572-0282
Monika Kuś Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0009-6445-5593
Grzegorz Słomkowski Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0003-3854-0248
Tymoteusz Białowąs Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0001-0889-2635
Dominika Karolak Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0007-1131-9171
Magdalena N. Nowak Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland https://orcid.org/0009-0002-1010-3364
Konrad Wiśniewski Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland https://orcid.org/0009-0007-1076-6471
Daria Valipur Kolti University Clinical Centre, Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0005-9900-4419
Kacper Cholewiński Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0004-7185-5310
Agnieszka E. Kierska Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0007-3387-8505

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5690

Keywords:

Myomectomy, Uterine Rupture, Laparoscopy, Laparotomy, Pregnancy Outcomes, Uterine Fibroids

Abstract

Background: Uterine rupture is a rare but potentially life-threatening complication of pregnancy following surgical procedures involving the uterine corpus, including myomectomy. The increasing number of laparoscopic procedures raises concerns regarding the safety of this approach in subsequent pregnancies.

Objective: To assess the risk of uterine rupture during pregnancy following laparoscopic myomectomy compared with open abdominal myomectomy based on current literature.

Materials and Methods: A literature review was conducted using the PubMed/MEDLINE database, including publications from 2014 to 2025. Cohort studies, population-based analyses, and systematic reviews comparing obstetric outcomes after laparoscopic and open myomectomy were included.

Results: The incidence of uterine rupture after myomectomy is low and does not exceed 1% in most analyses. Most comparative studies did not demonstrate significant differences between surgical approaches. Some population-based studies suggested a potentially higher risk following laparoscopic procedures; however, these findings are limited by methodological constraints.

Conclusions: Current evidence does not confirm a clearly increased risk of uterine rupture after laparoscopic myomectomy. The technique of uterine wall reconstruction and appropriate patient selection appear to be more important for obstetric safety than the surgical approach itself.

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