Myomectomy also known as fibroidectomy, is a surgical procedure of removing fibroids from the uterus. The reproductive potential of women is retained as the uterus is preserved.
When do you need myomectomy?
Myomectomy is done after you have been diagnosed with uterine fibroids. Your doctor would recommend it if the fibroids are interfering with your childbearing potential, it can cause fertility problems in the future or are causing heavy bleeding, pain and discomfort.
Different Types of Myomectomy
Abdominal myomectomy / Laparotomy
It is the most common technique of myomectomy that entails removing the fibroids by making a “bikini line” incision of about 4-6 inches in your abdomen just above the pubic bone. The fibroid is separated from the uterus which is then repaired by surgical procedures. Another technique involves making a vertical incision from below your navel. This technique can remove fibroids seated deep in uterus lining, multiple fibroids and large ones.
The technique involves combining hysteroscopy with myomectomty. The fibroids are removed by a lighted device called the resectoscope which is inserted via the vagina to access the uterus. However, this technique can be used to remove submucosal fibroids and not the deeper ones.
Laparoscopic and robotic myomectomy
These are minimal invasive techniques that assure less pain and quick recovery. The laparoscope or robotic instrument is inserted through the navel to locate the fibroids while the surgical instruments are inserted via small incisions made on your abdomen, below the navel in order to remove the fibroids. It works well when your fibroids are present on the outer wall of the uterus and occur in small number (1 or 2) and are small in size.
How to prepare for myomectomy?
Your doctor will first evaluate the fibroids attributing to their location, size, and risks. The type of myomectomy you will undergo will depend on this initial diagnosis.
Let your doctor know about the medicines and supplements you are taking and if you are allergic to anaesthesia. You might be asked to stop some medicines before surgery.
Follow the instructions given by your doctor regarding food and drinks. You need to keep your stomach empty for some time before surgery.
What happens during the procedure
All the three techniques of myomectomy are performed under general anaesthesia, so you won’t sense pain and discomfort.
During an abdominal surgery, a breathing tube will be placed in your throat and catheter will be inserted in your bladder to drain urine.
In case of hysteroscopic myomectomy, your doctor will inject a sterile salt solution into your uterus to expand your uterine cavity and then perform the surgery.
Abdominal myomectomy takes 1-2 hours for completion while other two procedures take lesser time.
What to expect after surgery
If you have undergone laparotomy, then you need to stay in the hospital for 1-4 weeks. Hysteroscopic myomectomy is an outpatient procedure and for laparoscopy, your hospital stay might be a day.
Recovery period for abdominal myomectomy is around 2-6 weeks while laparoscopic myomectomy takes 2-3 weeks and hysteroscopic myomectomy may require 2 weeks or less.
Follow the after-care instructions offered by your doctor and talk to your doctor about your probability of getting pregnant and how soon can you conceive. The good news is you will be relieved from the discomforts like heavy bleeding or periods, abdominal pain, pelvic pressure, etc. caused by the fibroids.
Are there any risks associated with the procedure?
Myomectomy is safe and the risks are rare. It could be scarring of uterine tissues due to the incisions and pelvic infection. The downside of abdominal myomectomy is- women might not be able to perform a normal delivery.
Written by: Saptakee sengupta
Date last updated: January 10, 2015