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What is Myomectomy?
Myomectomy is a surgical procedure in which fibroids are removed from the uterus wall.
Gonadotropin Releasing Hormone Analogue (GnRH-a) therapy may be used before myomectomy to reduce the size of the fibroids. This helps in reducing blood loss during a surgery. The GnRH-a therapy decreases the estrogen amounts in the body.
What are the different methods of performing Myomectomy?
Myomectomy may be performed by various surgical methods; choosing the method depends on the size, number and location of the fibroids.
How to prepare for Myomectomy?
Fibroids that are located on the inner wall of the uterus but have not grown deep into the wall of the uterus is removed by hysteroscopy. A hysteroscope is inserted through the cervix into the uterus and the fibroids are removed.
Fibroids that measure approximately 2 inches and are located outside the uterus is removed by laparoscopy. This method uses a laparoscope which is inserted through a small abdominal incision and the fibroids are located and removed.
Fibroids that are large in size or those that have grown deep into the wall of the uterus are removed by laparotomy. This is the traditional method of performing a myomectomy. During a laparotomy, a full abdominal incision is made horizontally or vertically. A few incisions are made in the muscles of the uterus and the fibroid is removed.
- The patient may be required to go through a hormone treatment 2 to 6 months before myomectomy to reduce the size of the fibroids.
- The patient needs to go through a thorough physical examination.
- The doctor should be informed if the patient is:
- Taking any medication
- Allergic to any medication
- Treated for any pelvic, uterine, cervical or vaginal infection 6 weeks prior to the procedure.
- Suffering from heart or lung ailments
- Arrangements should be made for someone to drive the patient home.
Days admitted : - Hysteroscopy: is done as an outpatient procedure.
- Laparoscopy: may be done as an outpatient procedure. However, sometimes patients may require a stay of 1 day in the hospital.
- Laparotomy: 1 to 4 days at the hospital
Anesthesia : General Anesthesia
Recovery : - Patients will be able to recover in a couple of weeks after myomectomy using laparoscopy and hysteroscopy.
- Patients who have had a laparotomy may need 4 to 6 weeks to recover.
- Patients’ symptoms of bleeding and pain caused by fibroids are cured after myomectomy.
- In many cases of patients with the problem of infertility, chances of pregnancy are known to be improved after myomectomy.
Risks : Risks involved in myomectomy are rare. They include:
- Uterine wall weakening
- Risks of anesthesia
- Severe bleeding that may lead to the removal of the whole uterus
- Uterine scarring may lead to infertility
- Rupture of uterine scars during pregnancy and delivery
After care : - The patient should follow the doctor’s instructions carefully.
- Patients trying to get pregnant may try to conceive 4 to 6 months after myomectomy because fibroids may grow back later.
- Patients may be required to do a hysterosalpingogram 4 months after myomectomy.
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