Myomectomy (Fibroid Removal surgery)
Myomectomy is a surgical procedure done to remove fibroids, keeping the uterus intact. The goal of Myomectomy is to remove the symptoms-causing fibroids & reconstruct the uterus.
Uterine Fibroids are non-cancerous growths inside the uterus and generally develop during the child-bearing years. Fibroids could be very small, undetected by naked eye to huge ones that distort the structure of uterus and even put on extra weight. Fibroids can cause painful periods and abnormal periods and may hinder conceiving.
The three surgical approaches to myomectomy
In this approach, an abdominal incision is made to access the uterus & remove the fibroids. One the following two incisions are used to enter the pelvic cavity.
- A horizontal bikini-line incision which runs about an inch above your pubic bone & causes less pain.
- A vertical incision which starts in the middle of the abdomen and extends from just below the navel to just above the pubic bone.
Laparoscopic or Robotic Myomectomy
- Laparoscopic myomectomy. A small incision is made in or near the bellybutton. A laparoscope, a narrow tube fitted with a camera, is inserted into the abdomen. The surgery is performed with instruments inserted through other small incisions in the abdominal wall.
- Robotic myomectomy. Instruments are inserted through small incisions and the movement of instruments is controlled by the surgeon from a separate console.
The fibroids are accessed & removed using instruments that are inserted through the vagina and cervix into the uterus.
Factors that increase the risk of getting fibroids
- Early onset of periods
- Having family history of fibroids
- Never having given birth
- Risk increases in late reproductive years
- Polycystic ovary syndrome (PCOS)
- Having had a multiple birth
- Use of the oral contraceptive pill
Symptoms of Fibroids
- Prolonged periods
- Frequent urination
- A pressure on the bladder, bowel or back
- Lower back ache
- A swelling in the abdomen
- Pain during periods & intercourse
Diagnosis of Fibroids
- A gynaecological examination.
- Pelvic ultrasound.
- During surgery for other conditions.
How long does it take to heal from myomectomy surgery?
Recovery time depends on the procedure. For abdominal myomectomy the recovery time is four to six weeks; for laparoscopic myomectomy its two to four weeks & for hysteroscopic myomectomy, its two to three days.
What happens if fibroids go untreated?
If left untreated, fibroids can continue to grow, both in size and number. As they take over the uterus, the symptoms will become worse.
How long after myomectomy can the patient get pregnant?
After a myomectomy, wait at least three months before attempting conception to allow the uterus enough healing time.