FIBROID REMOVAL SURGERIES (Myomectomy)
Myomectomy, a surgical procedure to remove uterine fibroids, is a vital option for individuals seeking to address these non-cancerous growths within the uterus while preserving fertility.
What is Myomectomy?
Myomectomy targets the removal of uterine fibroids, which can manifest in different locations within the uterus:
- Intramural fibroids: within the muscular uterine wall
- Submucosal fibroids: beneath the uterine lining
- Subserosal fibroids: on the outer uterine wall
For individuals desiring pregnancy, myomectomy presents an alternative to hysterectomy, as it leaves the uterus intact.
If fibroids exceed 4 centimeters, reside intramurally or submucosally, and the patient aims for fertility, surgical removal is recommended.
Myomectomy alleviates symptoms such as:
- Bleeding between periods
- Heavy menstrual bleeding
- Iron-deficiency anemia due to blood loss
- Pelvic pain and pressure
Moreover, the procedure mitigates the risk of severe health complications. “Fibroids within the endometrial cavity heighten the risk of second-trimester miscarriage,” notes Laimaa Fertility. In rare instances, fibroids may compress major veins, leading to life-threatening blood clots.
Types of Myomectomy:
Several myomectomy approaches exist, chosen based on factors like fibroid location, number, and size:
- Abdominal Myomectomy:
- Requires the longest recovery period and carries additional risks.
- Recommended in specific cases where benefits outweigh risks, considering fibroid size and number.
- Involves making an incision in the abdominal wall, usually horizontal or vertical midline.
- Benefits include enhanced accessibility to fibroids for palpation and quicker procedure duration compared to minimally invasive alternatives.
- Robotic-assisted or Laparoscopic Myomectomy:
- Minimally invasive procedures with shorter recovery times.
- Utilize small abdominal incisions and specialized instruments for fibroid removal.
- Recommended for most cases due to reduced risks and faster recovery.
- Hysteroscopic Myomectomy:
- Most minimally invasive option performed entirely through natural orifices.
- Suitable for fibroids not deeply embedded in the uterine wall, smaller than 4 centimeters, and submucosal.
- No incisions made, ensuring minimal trauma and rapid recovery.
Recovery:
- Abdominal Myomectomy: 4 to 6 weeks, with restrictions on heavy lifting and strenuous activity.
- Robotic-assisted or Laparoscopic Myomectomy: 2 to 3 weeks, with fewer limitations.
- Hysteroscopic Myomectomy: 1 to 2 days, with a quick return to normal activities.