Myomectomy is a surgical procedure used to remove fibroids from the uterus. It is, depending upon the surgical method used, considered to be a relatively straightforward procedure that can even be carried out on an out-patient basis.
Why is Myomectomy done?
There are several reasons why it may be carried out with the most common being:
- Heavy menstrual bleeding leading to the development of anemia
- Increased pelvic pressure that does not subside even after taking pain medication
- Fibroids that are causing difficulty in conceiving a child
The most common reason for a myomectomy being carried out is to improve the chances of pregnancy.
How is Myomectomy done?
Depending on the size and location of the fibroids, as well as the clinical judgment of the surgeon, myomectomy may be carried by:
- Hysteroscopy (the instrument is entered through the vagina)
- Laparoscopy (Only a few small cuts in the abdomen are given along with the use of a lighted instrument)
- Laparotomy (Larger incisions in the abdomen are given for direct accessibility)
If there are any other problems in the urinary tract or the bowels that need to be attended to then a laparotomy will have to be performed.
How successful is Myomectomy?
Myomectomy is considered to be one of the most reliable surgical procedures to help increase the chances of the patient getting pregnant, although there are certain things that need to be kept in mind. The recurrence rate of fibroids after the initial surgery has been carried out can range from 10-50%.
It has also been found that the recurring fibroids are often larger and more numerous than the ones that were removed. This is why it is essential for women looking to get pregnant that they attempt to do so right after recovery from the myomectomy procedure.
Women who do end up getting pregnant after myomectomy will probably need to undergo a cesarean section at the time of delivery.
Risks involved with Myomectomy
While the chances of complications with myomectomy are considered to be small, they do still exist.
There may be:
- Excessive blood loss during the time of surgery, which coupled with the likelihood of pre-existing anemia can be quite dangerous.
- Development of scar tissue after the surgery that can interfere with the nearby structures and even end up causing infertility.
- Depending upon the placement of the fibroids and the extent of surgery, myomectomy can lead to an increased likelihood of complications during the time of delivery.
- There is a very small chance that the surgeon may have to remove the uterus because of uncontrolled bleeding, the presence of cancerous growths or other complications discovered during the time of surgery.
A myomectomy is carried out if other methods to relieve the symptoms of uterine fibroids have not been successful. The procedure itself is meant to be carried out in women of child bearing age that plan on having a child after the fibroids have been removed and has been successful over a long period of time now.
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