What is Myomectomy? – Kinds, Risks & Complications

Myomectomy is a surgical process done to remove uterine fibroids. The surgical process is very similar to hysterectomy. Hysterectomy is done to remove the entire uterus, whereas Myomectomy only removes the uterine fibroids.

Uterine Fibroids, also known as leiomyomas or myomas, are noncancerous benign growth in the uterus, especially during childbearing age. It is a little difficult to diagnose and detect uterine fibroids because they vary greatly in size and don’t have any major symptoms.

What is Myomectomy? 

Myomectomy is a surgical procedure performed when women suffering from uterine fibroids experience major symptoms like excessive bleeding, painful periods, pelvic pain, etc.

Depending on the number of fibroids, size, and location, the doctors will decide which kind of uterine fibroid removal surgery will be performed.

Three major kinds of operative surgeries are:

1. Abdominal Myomectomy
2. Laparoscopic Myomectomy
3. Hysteroscopic Myomectomy

Kinds of Myomectomy 

1. Abdominal Myomectomy 

Abdominal Myomectomy occurs when excessively large fibroids are growing on the uterine wall and cannot be removed through Laparoscopic Myomectomy and Hysteroscopic Myomectomy.

For abdominal Myomectomy, the surgeon will make a large incision through the abdomen to access the uterus. The incision is made using a laser to reduce bleeding by closing off the blood vessels. After the fibroids have been successfully removed, the incision is stitched closed using sutures.

The recovery time is also long because it is an open surgical process. The patient will be in the hospital for observation for 2-3 days after the surgery.

It is best for women undergoing Abdominal Myomectomy to opt for Caesarean deliveries during future pregnancies.

2. Laparoscopic Myomectomy 

Laparoscopic Myomectomy is not possible when the uterine fibroids are large and embedded deep in the uterine wall. It is less invasive, and only small incisions are made on the lower abdominal area to allow entry for small surgical tools which will pull out the fibroids.

The tools used are a thin laparoscopic tube with a scope attached at the end. It is a minor surgical process and does not require patients to remain in the hospital for 2-3 days post-surgery.

They will keep you under observation overnight and allow you to resume your normal life the next morning.

3. Hysteroscopic Myomectomy 

Hysteroscopic Myomectomy removes uterine fibroids in the uterine cavity, not the uterine wall. Only submucosal fibroids are found in the uterine cavity and can be easily removed by this less invasive surgery.

For performing this procedure, a thin telescopic tube is inserted into the cervix by placing a speculum in the vagina. Once the telescopic is successfully inside, the uterine wall is slightly lifted, allowing the instrument to scrape off the fibroids.

Unlike Abdominal and Laparoscopic Myomectomy, this procedure does not leave any scars.

Why is a Myomectomy done? 

A person suffering from uterine fibroids condition might not necessarily experience symptoms. But a Myomectomy is a reliable way to treat the situation for those suffering from excessive symptoms.

Myomectomy can provide relief from various uterine fibroids symptoms like:

• Abdominal cramps
• Pelvic pain
• Heavy menstrual flow
• Burning during urinating
• Difficulty passing stool
• Pregnancy loss
• Infertility
• Enlarged uterus
• Constipation
• Diarrhoea

Are there any risks or complications involved? 

Myomectomy is performed by qualified surgeons, and there are few chances of any major risks or complications. Especially with Hysteroscopic Myomectomy, there are no risks involved as no incisions are involved.

Some risks and complications commonly associated with Abdominal and Laparoscopic Myomectomy are:

• Pain near the incision
• Abdomen tenderness
• High fever
• Excessive blood loss
• Scar tissue
• Damage to other organs
• Heavy vaginal bleeding
• Vaginal discharge
• Perforated uterus
• Scar tissue blocking the fallopian tubes
• Growth of new fibroids

If you take good care, there is nothing to worry about. The surgery will not affect your uterus and reproductive organs in the long run. You will be able to resume your normal sexual activities a few weeks after the surgery and be able to conceive.

What are the strategies to prevent possible surgical complications?

Make sure you have a proper conversation with your doctor to ensure surgery is the right step for you. Some uterine fibroids conditions can be treated through medication also. Therefore, before you go ahead with the surgery, understand all your options following your medical history, if any.

You can greatly reduce the risk of complications after the surgery by taking proper care of yourself. Your doctor will handle all the complications during the surgery if any, but it is your responsibility to follow strict post-surgery instructions.

Here are some things you must keep in mind while trying to prevent possible complications:

• After the Abdominal Myomectomy, try to get at least two weeks of rest
• Avoid standing for more than a minute for two weeks after the surgery
• Continue taking all your prescribed medicines diligently
• Visit a doctor immediately if you see symptoms like vaginal bleeding, infection at the wound site, etc.

Conclusion 

If you are of reproductive age and have symptomatic fibroids, do not worry. Myomectomy is suggested rather than hysterectomy to preserve fertility in the reproductive ages. In such a case, the procedure must be performed while keeping various factors in mind like size, location and number of the uterine fibroids. If many fibroids are removed at once, it can affect fertility.

However, there are fertility specialists who can perform Myomectomy and provide you with the right post-surgery preventive care. To meet an expert, visit Birla Fertility Clinic now and book an appointment with Dr. Pooja Bajaj.

FAQs :

1. Is a myomectomy like a C section? 

Yes, a Myomectomy is similar to a c-section however it is surgically performed, but the outcomes of both surgeries are different. A C-section is done to deliver a baby, whereas a Myomectomy helps remove uterine fibroids. Also, once a woman has been through this procedure, she will have to opt for a c-section in future pregnancies.

2. Can you get pregnant with a myomectomy? 

Yes, it is possible to get pregnant after you have undergone through a Myomectomy surgery. It is just a surgical process performed to remove uterine fibroids in women of reproductive ages. Myomectomy is often confused with a hysterectomy, but they are different surgical procedures.

3. Is pregnancy after Myomectomy high risk?

No, pregnancy after Myomectomy is not high risk, but you will not be able to do standard delivery after an Abdominal Myomectomy. You will have to opt for a c-section during childbirth. Some more lifestyle changes will also need to be implemented during the pregnancy.