Importance of myomectomy to prevent the growth of uterine fibroids.
The Happy couple after myomectomy surgery
Myomectomy means the surgical removal of fibroids. Myomectomy is a procedure of choice for women who have fibroids and do not wish to have a hysterectomy. Experienced gynaecological surgeons perform myomectomy through a keyhole (laparoscopic) or open abdominal surgery. Laparoscopic myomectomy is a complex laparoscopic surgery whose success is heavily reliant on the surgeon's knowledge and competence.
What precisely are uterine fibroids?
Fibroids are abnormal growths found in or near the uterus of women. These tumours can develop into large ones, causing severe abdominal pain and heavy periods. In some cases, they produce no visible signs or symptoms at all. The developments are normally noncancerous or benign. The aetiology of fibroids is still unidentified. The actual source of uterine fibroids is unknown. However, experts have believed that variables such as genetic abnormalities or estrogen and progesterone hormone fluctuations may have a role.
Uterine fibroids come in a variety of sizes and shapes. Hormones have a major role in the formation of uterine fibroids. This is why anti-hormone medicine can help reduce fibroids, but it's the only short-term treatment. Uterine fibroids, also known as leiomyomas, are benign muscular growths that have a low risk of turning cancerous.
What is myomectomy or fibroidectomy?
A myomectomy or fibroidectomy is a treatment that removes uterine fibroids from the uterus. Your doctor may advise you to have this procedure if your fibroids are causing symptoms such as:
- If you suffer from pelvic pain,
- If you have irregular or heavy periods,
- If you suffer from irregular bleeding,
- If you have frequent urination,
Gynaecological surgeons can perform myomectomy in one of three ways:
- The abdominal myomectomy procedure allows your physician to remove your fibroids through an open surgical cut in your lower belly.
- Your surgeon can remove your fibroids using laparoscopic myomectomy through a series of tiny incisions. It is MIS and has a quicker recovery time than abdominal myomectomy.
- Hysteroscopic myomectomy involves removing fibroids from your vagina and cervix with a specially designed scope.
What makes a myomectomy different from a hysterectomy?
A myomectomy procedure will permit you to have future pregnancies. You can expect periods in the usual way before the removal of fibroids. A myomectomy removes only the fibroids, leaving the uterus in place. Patients can expect the development of new fibroids. Myomectomy tends to result in more blood loss. Women who have completed their reproductive years and do not want to have more periods typically opt for a hysterectomy. A hysterectomy may remove the cervix or ovaries. There are three types of hysterectomy: vaginal, abdominal, and laparoscopic (MIS through small abdominal incisions).
Who is a perfect candidate for myomectomy?
Myomectomy is the best alternative for women with fibroids who want to conceive in the future or need to keep their uterus for other reasons. A myomectomy removes the fibroids while keeping the uterus intact. A Myomectomy gives you the option of having children later on.
How do you prepare for a uterine myomectomy?
Your doctor may recommend medicine to lessen the size of your fibroids and make them simpler to remove before surgery. Your doctor may put you on gonadotropin-releasing hormone agonists, as they block the production of estrogen and progesterone. Experts will put you into temporary menopause. Your menstrual cycle will resume once you stop using these drugs, and pregnancy should be feasible.
You may require testing to ensure that you are in good enough health to have surgery. Your surgeon will choose which tests you need based on your risk factors. These are some examples:
- Blood tests
- electrocardiogram
- MRI scan
- Pelvic ultrasound
You need to stop certain drugs before your myomectomy. Inform your doctor about your medicines, including vitamins, supplements, and over-the-counter medications. If you smoke, you should quit six to eight weeks before your operation. Smoking might impair your healing process and raise your risk of cardiovascular problems during surgery. When you consult with your doctor, you can ask him any questions regarding preparation and what to expect during the treatment.
What occurs throughout the course of the myomectomy?
The procedure will differ depending on what type of myomectomy you’re having.
Abdominal myomectomy
This procedure will require general anaesthesia. The surgery involves making a small incision in the lower abdomen and entering the uterus. A few options are available:
- Your surgeon may make a horizontal incision 3 to 4 inches long, just over your pubic bone. This incision in abdominal myomectomy causes less pain and leaves a smaller scar but may not be big enough to remove large fibroids.
- Your surgeon may make a vertical incision from just below your belly button to above your pubic bone. They rarely use this incision type today, but it may work better for larger fibroids and cut down on bleeding.
- Your surgeon will remove your fibroids from your uterine wall after the incision. Your doctor will stitch your uterine muscle layer together. Most women who have this operation stay in the hospital for one to three days.
Laparoscopic myomectomy
Your surgeon will make four tiny incisions while you are under general anaesthesia in your lower belly, and each of them will be roughly 12 inches long. It will fill your stomach with carbon dioxide gas, which will allow the surgeon to look into your abdomen. Your surgeon will insert a laparoscope into the incision. A laparoscope is a narrow, illuminated tube with a camera on one end. They will insert little tools into the other wounds.
A gynaecological surgeon may use robot techniques to operate surgical appliances remotely using a robotic arm. Your surgeon may chop your fibroids into small pieces to extract them. The surgeon may perform an abdominal myomectomy if they are too big, which involves making a larger incision in your belly. Afterwards, your surgeon will remove the instruments, release the gas, and close your incisions. Patients who have this procedure stay in the hospital for one night.
Hysteroscopic myomectomy
You will get a local anaesthetic or general anaesthesia during this procedure. Your gynaecological surgeon will introduce a small, lighted scope into your uterus through your vagina and cervix. They will place a liquid in your uterus to widen it and allow them to see your fibroids more clearly. Your surgeon will use a wire loop to shave off pieces of your fibroid. Then, the liquid will wash out the removed sections of the fibroid.
Is myomectomy that effective?
Most women get relief from symptoms such as pelvic pain and excessive bleeding after surgery. Fibroids can, however, reappear following a myomectomy, especially in younger women.