What is Myomectomy used for?
Myomectomy is a surgical procedure used to remove uterine fibroids, which are noncancerous growths that appear in the uterus. It is performed to alleviate symptoms caused by these fibroids, such as heavy menstrual bleeding and pelvic pressure. Unlike a hysterectomy, which involves removing the entire uterus, a myomectomy only removes the fibroids, preserving the uterus. Women who undergo myomectomy often report improvement in their fibroid-related symptoms.
How to prepare for Myomectomy?
Before a myomectomy, you should:
- Discuss your medical history and any medications you are currently taking with your doctor, as they may need to adjust your medication routine in the days leading up to the procedure.
- Follow your doctor's recommendations regarding fasting and stopping any food or drink intake in the hours before the procedure.
- Inform your doctor about any over-the-counter medications, vitamins, or dietary supplements you are taking.
The specific patient preparations may vary depending on the type of anesthesia, the procedure being performed (hysteroscopic, laparoscopic, or abdominal myomectomy), and any individual health considerations. It is important to have an open discussion with your doctor to understand the specific preparations required for your upcoming myomectomy.
How is Myomectomy conducted?
A myomectomy is a surgical procedure to remove uterine fibroids. The procedure can be performed in different ways, including abdominal myomectomy (laparotomy), laparoscopic myomectomy, and robotic myomectomy. During an abdominal myomectomy, the surgeon makes an open abdominal incision to access the uterus and remove fibroids. In laparoscopic or robotic myomectomy, the surgeon accesses and removes fibroids through several small abdominal incisions. The surgery involves the use of various instruments, such as a resectoscope or hysteroscopic morcellator, to remove the fibroid pieces from the uterus. In some cases, if the fibroid is too large, it may require multiple surgeries to remove completely. During the procedure, a clear liquid is usually inserted into the uterus to expand the uterine cavity and allow the surgeon to examine the uterine walls. The surgeon then shaves pieces from the fibroid using the instrument and removes them from the uterus. Women who undergo myomectomy often experience improvement in fibroid symptoms, such as heavy menstrual bleeding and pelvic pressure. The choice of surgical approach depends on factors such as the size, number, and location of the fibroids.
Understanding the report
Myomectomy results are interpreted in terms of the success of removing uterine fibroids and the improvement of symptoms caused by the fibroids. After the surgery, patients are typically monitored for changes in heavy menstrual bleeding, pelvic pressure, and other associated symptoms. The surgery's success is evaluated based on how much the symptoms improve and whether the patient plans to bear children in the future. If the fibroids are completely removed and symptoms are significantly reduced, the myomectomy is considered successful.
Limitations and Considerations
Myomectomy, as a surgical procedure, does have limitations to consider. Some of these include:
- Recurrence: Uterine fibroids may grow back after a myomectomy, particularly if the underlying hormonal imbalances are not addressed. This can lead to a need for additional surgeries in the future.
- Incomplete removal of fibroids: In some cases, it may be difficult for the surgeon to remove all fibroids, particularly if they are deeply embedded in the uterine muscle or have extensive roots. Fibroids that are left behind may continue to cause symptoms or grow over time.
- Damage to the uterus: Myomectomy can cause damage to the uterus, including scarring, adhesions, or weakening of the uterine muscle. These complications may increase the risk of future pregnancy complications or the need for a hysterectomy.
- Hysterectomy risk: Although uncommon, there is a small chance that a hysterectomy may be necessary during the myomectomy procedure if unexpected complications arise, such as uncontrollable bleeding.
- Risks of anesthesia and surgery: Like any surgical procedure, myomectomy carries general risks associated with anesthesia and surgery, such as infection, bleeding, or reactions to anesthesia.
It is essential to discuss the potential limitations and risks of myomectomy with your doctor to help you make an informed decision about your treatment options.