Gynaecology

Myomectomy

Description

Myomectomy refers to the procedure to the removal of uterine fibroids through open-surgery. Fibroids can produce pregnancy complications and cause intense pain in pelvic and back. Fibroids in the uterus can occur at any age and unlike hysterectomy, where the entire uterus is removed, myomectomy only involves removing the fibroids and hence is called fibroid removal surgery.

Patients suffering from back or pelvic pain, abnormal vaginal bleeding, discomfort during sex, pregnancy issues or pressure on the bladder can benefit from myomectomy. These symptoms are usually caused by fibroids, which can be removed surgically. Myomectomy also helps restoring the menstrual cycle to normal. Your doctor may suggest myomectomy if you plan to bear a child, but are unable to do so and fibroids are the likely cause.

Preparations are done before the surgery begins, which include not eating or drinking hours prior to the surgery and state your current medical conditions along with the prescriptions you are on. You also need to tell him about any possible side effects that you may have with anesthesia or latex. Medical tests may also be performed to verify your fitness for the surgery.

Once all the preparations are made, you will be given general anesthesia to put you to sleep. A therapy called shrinking fibroids with gonadotropin releasing hormone analogue may be given to reduce the amount of blood loss during the surgery .

Myomectomy surgery of three types:

  • Hysteroscopy: This process involves inserting a small, light instrument called a resectoscope into the uterus through the vagina or cervix to access and remove the fibroids.
  • Laparotomy: This process involves making an incision through the abdomen and reaching the uterus to remove the fibroids. The surgeon may enter the pelvic either through a horizontal bikini like incision or a vertical incision.
  • Laparoscopic: This is a minimally invasive procedure in which the doctor access and remove the fibroids from many small incisions made in the abdomen. A narrow tube with a camera is inserted into the abdomen and surgery is performed from other incisions.

The choice of treatment procedure is made by the doctor depending upon the size, number and location of the fibroids.

Mymomectomy in India is rountinely offered across hospitals.

Complications

Every surgery involves some sort of complications and myomectomy as well possess some rare risks. The risks will be reviewed to you by your doctor before the procedure. Some of the risks associated with Mymomectomy are:-

  • Infection
  • Bleeding
  • Organ damage
  • Recurrence
  • Anesthesia related complications
  • Weakened uterus
  • Bowel blockage
  • Increased pain
  • Scarring
  • Infertility
  • Constipation
  • Nausea and vomiting
  • Headaches
  • Frequent urination

Post operative care

Once the procedure is done, you may require to stay in the hospital for 2-3 days. You will be shifted to the recovery room for further medical tests to see if any complications are occurring. Full recovery may take some 4-6 weeks.

Wear sanitary pads to absorb the blood, as the first menstruation after the surgery may be heavier than usual.

Make sure to call the doctor if you experience any of the above mentioned after effects along with redness and swelling on the surgical site.