myomectomy
Myomectomy is a surgery done to remove fibroids. Symptomatic Fibroids are operated. Even these days most myomectomies are performed by an open surgery. It can also be done laparoscopically. With faster recovery and early return to normal activities this method should be considered the preferred for many
Why it's done
Your doctor might recommend myomectomy for fibroids causing symptoms that are troublesome or interfere with your normal activities. If you need surgery, reasons to choose a myomectomy instead of a hysterectomy for uterine fibroids include:
- You plan to bear children
- Your doctor suspects uterine fibroids might be interfering with your fertility
- You want to keep your uterus
Ways to do myomectomy
- Laparoscopy
- Laparotomy (open)
- Hysteroscopy
Laparoscopic myomectomy
In laparoscopic or minimally invasive procedures, your surgeon accesses and removes fibroids through several small abdominal incisions.
The fibroid is cut into smaller pieces and removed through these small incisions in the abdominal wall or, rarely, through an incision in your vagina (colpotomy).
This means you may have less pain, lose less blood and return to normal activities more quickly than with a laparotomy. Uterine size and fibroid number and location are factors in determining when laparoscopic surgery is appropriate.
How you prepare
Here's what you can do to prepare:
- Gather information. Before surgery, get all the information you need to feel confident
- Follow instructions about food and medications. You'll need to stop eating or drinking anything in the hours before your surgery.
- If you're on medications, ask your doctor if you should change your usual medication routine.
- Discuss the type of anesthesia and pain medication you may receive.
- Arrange for help.
- Plan for a hospital stay if necessary. Whether you stay in the hospital for just part of the day or overnight
Not all surgeons are trained in laparoscopic surgery; because of the small size of the incisions, removing uterine fibroids with laparoscopic myomectomy requires special training.
how to prevent possible surgical complications
To minimize risks of myomectomy surgery, your doctor may recommend
- Iron supplements.
- Hormonal treatment.
- Therapy to shrink fibroids.
Hysteroscopic myomectomy
To treat fibroids that bulge significantly into your uterine cavity (submucosal fibroids), your surgeon may suggest a hysteroscopic myomectomy. Your surgeon accesses and removes fibroids using instruments inserted through your vagina and cervix into your uterus.
Risks of myomectomy
Myomectomy has a low complication rate. Risks of myomectomy include:
- Excessive blood loss.
- Scar tissue. Laparoscopic myomectomy may result in fewer adhesions than abdominal myomectomy
- Childbirth complications. the doctor who manages your subsequent pregnancy may recommend cesarean delivery (C-section) to avoid rupture of the uterus during labor, a very rare complication of pregnancy.
- Rare chance of hysterectomy.
When you go home
- At discharge from the hospital,
- your doctor prescribes oral pain medication,
- tells you how to care for yourself,
- and discusses restrictions on your diet and activities.
- your doctor may advise that you not use tampons or have sexual intercourse during recovery.
- You can expect some vaginal spotting or staining
- Abdominal myomectomy recovery typically takes four to six weeks.
- Laparoscopic myomectomy recovery typically takes two to three weeks.
- Hysteroscopic myomectomy recovery typically takes less than a week.
POINTS TO REMEMBER
- fibroids can present with or without symptoms
- not all fibroids are operated
- laparaoscopic myomectomy is an excellent method for fast recovery