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MYOMECTOMY
A myomectomy is a medical procedure that removes fibroids while preserving the uterus. For women who experience fibroid symptoms and want to bear children in the future, myomectomy is the best treatment option.

Myomectomy is highly effective, but fibroids can re-grow. The younger you are and the more fibroids you have at the time of myomectomy, the more chance you are to develop fibroids again in the future. Women close to menopause are the least likely to have recurring issues from fibroids after a myomectomy.

A myomectomy can be done in several different ways. Depending on the size, amount and location of your fibroids, you may be eligible for an abdominal, laparoscopic or a hysteroscopic myomectomy.

Abdominal Myomectomy
Also referred to as an "open" myomectomy, an abdominal myomectomy is a major surgical operation. It entails making an incision through the skin on the lower abdomen, referred to as "bikini cut," and removing the fibroids from the wall of the uterus. The uterine muscle is then sewn back together using multiple layers of stitches. You will be asleep in the course of the procedure.

Blood loss during the operation may need a blood transfusion. Some women store their blood before the operation in order to receive their own blood instead of blood from the blood bank.

Most women spend two nights in the hospital and four to six weeks to recover at home. After the operation, you will have a four-inch horizontal scar close to your pubic hair or "bikini" line.

After a myomectomy, your doctor may suggest a Caesarean section (C-section) for the delivery of future pregnancies. This is to reduce the possibility that your uterus could open apart during labor. The need for C-section will depend on how severely the fibroids were embedded in the wall of the uterus at the period of surgical removal.

It is also essential to note that new fibroids may develop, leading to recurrent symptoms and additional procedures.

Risks
Just like any surgical procedure, an abdominal myomectomy does have some risks, though very uncommon. About 5 percent of women have an infection after surgery that is treated with antibiotics in the hospital for as many as five days. Around 5 percent of women may develop a wound infection. In as much as the wound infection is treated at home, frequent visits to the hospital for up to six weeks are required.

Laparoscopic Myomectomy
Only few fibroids can be removed by a laparoscopic myomectomy. If the fibroids are big, numerous or deeply embedded in the uterus, then an abdominal myomectomy may be needed. Also, at times during the operation it is necessary to change from a laparoscopic myomectomy to an abdominal myomectomy.

You will be asleep in the course of the procedure, which is performed in the operating room. At first, four one-centimeter incisions are made in the lower abdomen: one at the navel (belly button), one under the bikini line (near the pubic hair) and one close to each hip. The abdominal cavity is then pumped with carbon dioxide gas. A thin, lighted telescope, called a laparoscope, is positioned through an incision, allowing doctors to see the ovaries, fallopian tubes and uterus. Long tools, inserted through the other incisions, are used to remove the fibroids. The uterine muscle is stitched back together. At the end of the operation, the gas is released and the skin incisions are closed.

Usually most women spend one night at the hospital and two to four weeks recovering at home. After the surgical procedure, you will have little scars on your skin where the incisions were made.

Risks
Like any surgery, a laparoscopic myomectomy does have some risks, though uncommon. Complications can include injuries to internal organs and bleeding. Also, your uterus may be weakened after surgery. Therefore, women planning to become pregnant in the future are often encouraged to have an abdominal myomectomy.

It is also vital to note that new fibroids may grow, resulting in recurrent symptoms and additional procedures.

Hysteroscopic Myomectomy
Only women with submucosal fibroids are qualified for a hysteroscopic myomectomy. Fibroids located in the uterine wall cannot be removed with this process.

This is an outpatient surgical procedure in which the patient is usually asleep. During the surgery, you will lie on your back and your feet held in gynecology stirrups. A speculum is positioned in the vagina. A long, slender "telescope" is inserted through the cervix into the uterine cavity. Fluid is applied into the uterine cavity to lift apart the walls. Tools passed through the hysteroscope are used to shave off the submucosal fibroids.

After the procedure, you will be allowed to go home after several hours of observation in the recovery room.

You may notice cramping and light bleeding after the procedure. Typical recovery involves one to four days of relaxation at home. You will not have any scars on your skin after the surgery.

Disclaimer: The information provided herein is for patient general knowledge only and should not be used during any medical emergency, diagnosis or treatment of any medical condition. Duplication for personal and commercial use must be authorized in writing by Surjen.com.

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