Myomectomy and Uterine Fibroids

Myomectomy is a treatment for Uterine uterine fibroidsleiomyomata, also known as uterine leiomyomata,or myoma. (fibroids)

What are Uterine Fibroids?

Fibroids are benign growths of the uterus, which are almost always benign. The prevalence is approximately 30 to 40% of women. Most uterine fibroids are asymptomatic and patients do not even know they have them. In some patients they can cause abdominal pain, irregular bleeding, and sub-fertility.

Uterine myomas can be small or large. They can grow inside the uterine cavity (where pregnancies develop), in the uterine muscle wall itself, and can attach to the uterine surface.

Fibroid Symptoms:

Most fibroids are asymptomatic, but some can cause:

  1. Heavy bleeding with periods
  2. Increased pain with periods.
  3. Spotting throughout the month.
  4. Anemia or low blood counts.
  5. Pain in the abdomen and back.
  6. Difficulty with bowel movements and increased urination.
  7. Sub-fertility and miscarriage.

If your fibroid is protruding into the uterine cavity your physician may counsel you to have it removed.

Diagnosing Uterine Fibroids

Most fibroids are diagnosed with transvaginal ultrasound. If your uterine fibroid is close to or protruding into your uterine cavity, your physician may have you obtain a hysterosalpingogram or a saline sonogram to better map out the relationship of your fibroids to the uterine cavity.

Myomectomy as a Treatment

With regard to fertility treatments and pregnancy outcomes, fibroids that do not protrude into your cavity may be left alone. Especially, if there are no symptoms because the fibroids are small. However, in some cases the fibroids will affect fertility, and a myomectomy will be necessary to remove them.



Abdominal Myomectomy

Abdominal myomectomy is a surgical procedure which removes fibroids through an incision on your abdomen. The incision is usually placed horizontally (bikini). This procedure is done in the hospital and most patients stay for 2 to 3 days before they go home.

At the time of the abdominal myomectomy, all detectable uterine fibroids are removed and the uterus is reconstructed. Often, at the same time, blue dye is placed in the cervix so that we can make sure your fallopian tubes are open prior to performing your myomectomy.

Risks of Abdominal Myomectomy:

Risks of abdominal myomectomy include: bleeding, infection, injury to other abdominal organs, and the possibility of hysterectomy at the time of myomectomy (this happens less than 1% of the time).

If after your surgery you experience fevers, wound infection or abdominal pain, alert your nurse or physician.

Abdominal Myomectomy Recovery Time:

Most patients return to work within 4 weeks though some may take 6 weeks for the complete recovery.

Your physician may offer you Lupron® or Cetrotide® prior to surgery. It is used to temporarily shrink fibroids prior to surgery. This will make your surgery easier and help build your blood count up prior to surgery.



Hysteroscopic Myomectomy

Fibroids that protrude more than 50% into the cavity can be removed using the hysteroscope with a resecting loop. A resecting loop is a tiny wire loop can be placed through the hysteroscope and allow your physician to remove your fibroid deep into the wall of the uterus. A hysteroscopic myomectomy is an outpatient procedure and is used for the removal of small protruding fibroids that enter the uterine cavity.

Recovery Time of Hysteroscopic Myomectomy

Patients are discharged home the same day. You will be able to go to work the next day.

Notify your nurse or physician if you experience fevers or abdominal pain after your hysteroscopic myomectomy.

 

Contact us for more information about myomectomy.
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