Myomectomy

Myomectomy is a type of surgery used to remove uterine fibroids, which are noncancerous growths that appear in the uterine wall. Myomectomy is the preferred treatment for fibroids in women who want to keep their uterus. Depending on the location of the fibroids, the procedure can be done through the pelvic area or through the vagina and cervix.

If the doctor has discovered that uterine fibroids are present, then they may recommend a myomectomy. Symptoms associated with uterine fibroids are:

• Pelvic pain
• Heavy periods
• Irregular bleeding
• Frequent urination

Myomectomy is a good option for women who have fibroids and wish to become pregnant in the future. Unlike a hysterectomy, which removes the entire uterus, myomectomy removes the fibroids but leaves the uterus in place.

The doctor will recommend the appropriate procedure depending on the size and the location of the fibroids. The most common methods used for myomectomy are:

• Abdominal myomectomy — This procedure allows the doctor to remove the fibroids through an open surgical incision in the lower abdomen. This type of procedure is best women who have very large fibroids.
• Laparoscopic myomectomy — This procedure allows the doctor to remove the fibroids through several small incisions and may be done robotically. This method is less invasive, and recovery is faster than with abdominal myomectomy. This type of procedure is best for women with a few small fibroids.
• Hysteroscopic myomectomy — This procedure requires the doctor use a special scope to remove the fibroids through the vagina and cervix. This procedure may be best women who have smaller fibroids inside the uterus.

Before the surgery, the specialist to discuss your medical history and which type of procedure will be best for you. Your doctor may also prescribe medication to reduce the size of the fibroids to make them easier to remove.

Your doctor may conduct tests to make sure you’re healthy enough for surgery depending on certain risk factors. These tests can include:

• Blood tests
• Electrocardiogram, a simple test that measures the heart’s electrical activity
• MRI scan
• Pelvic ultrasound

If your doctor has prescribed myomectomy to remove uterine fibroids, there are several preparatory measures that need to be addressed first:

• You may need to stop taking certain medications before the surgery — make sure you disclose what medications you take, including vitamins, supplements, and over-the-counter medications
• Stop smoking — if you smoke, stop six to eight weeks before the surgery. Smoking can slow the recovery process as well as increase your risk of cardiovascular events during the surgery
• No eating or drinking after midnight the night before the surgery

You will most likely be able to go home the same day as the surgery. You will likely experience some pain after the procedure, and your doctor will provide medication to treat the discomfort. You may also have spotting for a few days to several weeks.

 Recovery time before you can return to normal activities depends on what type of procedure you have. Recovery times for each type are:

• Abdominal myomectomy: four to six weeks
• Laparoscopic myomectomy: two to four weeks
• Hysteroscopic myomectomy: two to three days

Your doctor will advise you to avoid any heavy lifting or strenuous exercise until the incisions have fully healed. You will also be advised against having sex or using feminine hygiene products during your recovery after the procedure.

If you are trying to get pregnant, ask your doctor when you can safely start trying. Your doctor may recommend you wait three to six months for the uterus to fully heal, depending on which kind of surgery you’ve had.

Unusual side effects which could indicate complications include fever, chills, intense bleeding more than a couple days after the procedure, strong smelling discharge, trouble urinating, or severe pain. If you experience any of these, call your doctor immediately.

For more information, schedule an appointment today or call us to speak with one of our patient coordinators.