Myomectomy Surgery

What is Myomectomy?

Myomectomy is a surgical intervention used to treat uterine fibroids without having to remove the uterus, as in the case of a hysterectomy.

The procedure is primarily recommended for women who wish to get pregnant in future as it focuses on removing the fibroids while leaving the uterus tissue intact.

Myomectomy helps to relieve pelvic pain, menstrual irregularities and other symptoms associated with uterine fibroids, allowing you to lead a better quality of life.

Who is the candidate for Myomectomy?

Myomectomy is recommended for women with uterine fibroids or leiomyomas, which happens to be one of the most common uterine growths seen in women of childbearing age.

Uterine fibroids are non-cancerous and do not generally have a known cause. While small fibroids are not usually a cause of concern, larger ones can disrupt normal menstruation and give rise to complications like severe pain, heavy bleeding and even infertility.

What are the indications of Myomectomy?

Myomectomy is an option for

• Women with symptomatic fibroids, including those who have severe menstrual bleeding, pelvic pressure or pain, or urine retention.
• Women who have fibroids that can interfere with their ability to conceive or have a normal pregnancy
• For women who want to keep their uterus instead of having a hysterectomy, due to personal or cultural reasons

Types of Myomectomy:

Depending on various factors like the location, size, number and type of fibroids, doctors use varied approaches to perform myomectomy. Based on these, the procedure can be of the following types:

• Abdominal Myomectomy: It uses the conventional technique, in which doctors access the uterus by making a horizontal or vertical incision on the abdominal wall. This is generally recommended if there are too many fibroids or if the fibroids are too large.
• Laparoscopic Myomectomy: It is a minimally invasive alternative that allows doctors to precisely remove the fibroids via keyhole incisions, with the help of imaging guidance offered by a surgical camera. It is the best approach for removing smaller fibroids.
• Hysteroscopic Myomectomy: It is the least invasive technique that uses hysteroscopy for removing or shaving off the fibroids that develop within the uterine cavity. The hysteroscope is introduced inside the body using a transvaginal approach, without the need for any incisions.

Preparation

At Surya Hospital, we brief our patients about the procedure. and what to expect after it, in order to prepare them for the surgery.

In order to determine the best course of treatment, a series of tests may be performed for thorough evaluation. Our experts will assess your medical history and perform a physical examination followed by blood analysis and imaging tests like MRI and ultrasound.

Women who have larger fibroids may be required to take medications to reduce their size and make it possible to remove them more efficiently.

Guidelines related to nutrition and lifestyle changes, to improve health and lower surgical risks, are provided prior to surgery.

Procedure

The procedure varies depending on the type of myomectomy.

• Abdominal Myomectomy involves the use of general anaesthesia and is performed by following the conventional technique. Doctors access the uterus by making a 3 to 4-inch-long incision on the lower abdomen or a vertical incision below the belly button. The fibroids are then carefully removed from the uterus wall and the incision is closed.
• Laparoscopic Myomectomy is also performed under the influence of general anaesthesia, by making 2 - 3 keyhole incisions, around ½ inch long, to introduce the laparoscope and surgical equipment. The abdominal cavity is inflated using carbon dioxide gas, for better access and visualization. The fibroids are removed carefully and the incision is closed.
• Hysteroscopic Myomectomy is performed using either general or local anaesthesia. The hysteroscope is introduced via the vaginal opening. A medicated solution may be used to allow better visualization. Using special equipment, the fibroids are scrapped off or removed. The liquid is then drained, which also allows the scrapped fibroid pieces to flush out.

Recovery

Surya Hospitals is committed to offering the best possible care to women who are suffering from uterine fibroids. Through myomectomy surgery, we work to meet your individual requirements, whether they involve regaining fertility or treating symptoms. Your medical staff will assist you in recovering following the procedure:

• Hospital Stay: The length of your hospital stay is determined by the surgical procedure and how well you are recovering on an individual basis.
• Pain Management: You will be given medication to treat any discomfort or pain you may feel.
• Physical Exercise: At first, you will need to restrict physical activity and stay away from strenuous lifting to aid in healing.
• Scheduled follow-up visits: Follow-up visits with your gynaecologist will be made to check on your progress and address any issues.
• Upcoming Pregnancies: Your gynaecologist will talk about the best time to try getting pregnant if fertility preservation is a top aim.