Obstetrics & Gynecology
A myomectomy is a surgical procedure that is performed to remove uterine fibroids; non-cancerous tumors of the uterus. Uterine fibroids may cause troublesome symptoms such as heavy menstrual bleeding and pelvic pain and pressure. Conservative treatments are initially used to treat uterine fibroids, but if they are not effective, surgery may be necessary. In some cases, a hysterectomy may be performed as treatment for uterine fibroids. However, after a hysterectomy a woman will not be able to bear children, due to the removal of the uterus. Therefore, a myomectomy is an effective treatment option for women considering having children in the future.
Types of Myomectomy Procedures
Depending on the type or size of the fibroids, the myomectomy procedure can be performed through several different techniques.
Abdominal myomectomy is performed by making vertical incisions in the abdominal wall to access fibroids that require removal. The procedure is performed under general anesthesia. Full recovery is expected in approximately four to six weeks.
A hysteroscopic myomectomy uses a tool called a resectoscope. The resectoscope is inserted through the vagina, and releases a liquid to expand the uterus and then shave away the fibroid pieces. The fibroid tissue is then flushed from the uterus.
Laparoscopic or Robotic Myomectomy
During a laparoscopic or robotic myomectomy, a laparoscope with a small tube with a camera, is inserted into the pelvis. This tool is used to remove fibroids through small incisions made in the abdomen. Laparoscopic patients are usually released the same day.
After any myomectomy procedure, vaginal spotting may occur. Patients may also be advised to avoid physical activities, heavy lifting and sexual intercourse for several weeks after the procedure.
Risks of Myomectomy
Although these procedures are generally considered safe, common risks may include:
- Blood clots
- Minor blood loss
- Damage to pelvic structures
In rare cases, if bleeding is uncontrollable during the myomectomy procedure, a hysterectomy may be necessary.
Considerations of Myomectomy
Most women who undergo a myomectomy procedure experience significant relief of symptoms. While women who undergo myomectomy will still be able to bear children, the procedure may have an effect on fertility due to scarring that can be incurred during surgery. Women who have undergone a myomectomy are more likely to give birth via cesarean section in the future.