Myomectomy

Myomectomy Procedure, Types & Risks

There are several procedures with the focus on removing the benign uterine fibroids. One of such procedures is a surgical one and it is called Myomectomy. 

A uterine fibroid refers to a benign and non-cancerous growth that appears on the uterus of women during the years that they are able to bear a child. However, there have been cases of these occurring at other times as well.

In this procedure, the surgeon removes the uterine fibroids and then reconstructs the uterus. This is not a hysterectomy, to that end, there is no removal of the entire uterus, but rather the removal of the growths and reconstruction of the uterine region.

Why choose this over hysterectomy?

The reasons to choose Myomectomy over hysterectomy are as follows: 

  • Hysterectomy is a more drastic measure and is used to deal with cancerous tumours at most times. 

  • If you plan to bear children, this is the method to go for as it preserves the uterus.

  • If uterine fibroids are interfering with your fertility, choose Myomectomy. 

Preparation before the procedure

The preparation for the surgery entails the following: 

  • A few hours before the procedure, you should not drink or eat anything. 

  • Your usual medications are going to be changed before the procedure.

  • You will then be given the option to choose from general anaesthesia or local anaesthesia.

What are the several types Myomectomy?

The types of Myomectomy are as follows: 

1. The abdominal Myomectomy: this process entails making an incision in the abdominal region in order to get access to the uterus and remove fibroids. 

There are two types of incisions:

  • Vertical incision: This incision is done in the middle abdominal region and it extends from below the navel to the pubic bone.

  • Horizontal incision: They run an inch above the pubic bone.

2. Minimally invasive Myomectomy: these are the minimally invasive procedures and there are two kinds of this form:

  • Laparoscopic Myomectomy: A small incision is made near the belly button and a laparoscope is then inserted. Then the process takes place.

  • Robotic Myomectomy: it entails the insertion of small remotely controlled instruments via the laparoscopic incision.

3. Hysteroscopic Myomectomy: This is the case that is considered when the size of the fibroids is a much larger than expected. In this:

  • A resectoscope is inserted through the incision and either electricity or laser beam is used to remove the fibroids.

What are the risks associated with this procedure?

This particular procedure entails the following risks:

  • Excessive blood loss: Women who are opting for this procedure for the duration of their periods, the risk of blood loss is high. To that end, blood build up is recommended before the surgery.

  • Scar tissue: after the surgery, the incisions that have been used to make a pathway towards the uterus have a large possibility of leaving scar tissues. These are called adhesions and they end leading to light menstrual periods. 

  • There is also a risk to the pregnancy for women: this procedure has the chance of increasing the complications during pregnancy. 

  • There is a chance that hysterectomy has to be performed if either the bleeding is uncontrollable or the fibroids are way too big. 

  • If the fibroids are not recognized as benign by mistake, there is a chance for cancer for spreading.

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Senior Gynecologist and a Senior Consultant

Dr. Madhu Goel is a well renowned senior gynaecologist and a senior consultant at Fortis La femme, New Delhi. She runs a private consultation in Goel’s surgery and Gynea centre and prior to being associated with Fortis; she was a consultant a Rockland Hospital.