What is myomectomy?
A myomectomy is a surgical approach for uterine fibroids removal. If the symptoms are causing the below-mentioned problems, then the doctor will suggest surgery:
- Pelvic Pain
- Heavy periods
- Irregular bleeding
- Frequent urination
What are the ways to carry out myomectomy?
The doctor will carry out the myomectomy in different ways:
- Abdominal Myomectomy : Through this approach, the surgeon will remove fibroids by making a surgical cut in the lower belly.
- Laparoscopic Myomectomy: Through this approach, the surgeon removes fibroids by making a small incision. The robotic approach is used. The procedure is less invasive and you can recover faster as compared to the abdominal myomectomy.
- Hysteroscopic Myomectomy: In this approach, the fibroids are removed through the surgical approach from the cervix and vaginal area.
Who is the eligible candidate for myomectomy?
Myomectomy is the desirable choice for women with fibroids who want to conceive in the future or who want to keep the uterus for some reason. Basically, through this approach, only the fibroids are removed and the uterus will stay in its place. It means if you want to try to conceive in the future you can do that with ease. The doctor will determine the treatment plan as per the location and size of the fibroid:
- Large Fibroids: Large fibroids in the uterine wall and many in numbers are best treated with abdominal myomectomy.
- Smaller Fibroids: Smaller fibroids and fewer in number are best treated with laparoscopic myomectomy.
- Fibroids in the uterus: Hysteroscopic myomectomy is a better choice with small fibroids and their presence is inside the uterus.
How do you prepare for surgery?
Before the surgery, the doctor will suggest certain medication which reduces the size of the fibroid and allows them to be removed easily. Through the intake of lupron, the production of progesterone and estrogen is blocked. This allows the menopause state to be temporary. Once you stop the intake of this medication, the menstrual cycle will come back to its normal state & the pregnancy
During the consultation, you must talk to the doctor. You must ask as many questions as you can about the surgery like what to expect, preparation method, and after-care. You need to get a certain test to ensure that your health is proper. The doctor will suggest the test by determining the risk factors which includes:
- MRI scan
- Pelvic Ultrasound
- Blood tests
What happens during the procedure?
The procedure will differ depending on what type of myomectomy you’re having.
This procedure is done under general anesthesia. The incision is made on the lower abdomen in the uterus. The procedure is done in the following ways:
- A horizontal incision 3 to 4 inches long, over your pubic bone. This type of incision leaves a smaller scar and results in less pain.
- A vertical incision just below your belly button to above the pubic bone. Although such incision is not used much and it can be best for women with large fibroids.
You are under the effect of general anesthesia and the surgeon makes 4 small incisions. On the lower abdomen, around the ½-inch long incision. The belly area is filled with carbon dioxide gas which helps the surgeon to view the abdomen.
The surgeon will place the laparoscope in one of the incisions. With a laparoscope, there is a lighted tube and the camera on one end.
If the surgery is done robotically, the surgeon will control the instruments through the robotic arm.
The patient is given general anesthesia or local anesthesia during the surgery. Through the vagina & cervix then to the uterus, thin lighted scope is inserted. After that, the uterus is widened by inserting the liquid and the surgeon can see the fibroids. Once, everything is done, the liquid is removed.
What to expect?
If the uterine fibroids are resulting in problems then it is important that you get them removed & this way you will get relief from symptoms.