An Overview of Myomectomy for Fibroids

A myomectomy is a surgery performed to remove fibroids from the uterus. This procedure preserves the uterus so the woman can go on to have children in the future. Fibroids cause heavy bleeding, pelvic cramps, and infertility. The type of myomectomy depends on the size, location, and number of fibroids.

Abdominal Myomectomy

Also called an open myomectomy, the abdominal myomectomy is a major procedure. This involves a small incision through the lower abdomen, which is called a bikini cut. The fibroids can be removed through the uterus wall, after the uterine muscle is incised. The muscle and skin are sewn back together using layers of stitches.

The myomectomy is performed using general anesthesia (you are put to sleep), so minimal pain is involved. Because blood loss occurs during this procedure, women donate their own blood beforehand. After the myomectomy, the woman must have a Caesarean section (C-section) for future pregnancy deliveries.

Laparoscopic Myomectomy

Fibroids can be removed using laparoscopic myomectomy. This involves making four small incisions around the navel, hip, and bikini line. The small laparoscope is inserted into the uterus to identify the fibroid and make necessary removal. Long instruments can be inserted into the incisions to remove the tissue. Afterwards, the uterine muscle is sewn back together. Most women spend the night in the hospital following the procedure, and 2-4 weeks recovering at home.

Hysteroscopic Myomectomy

Women with small submucosal fibroids can undergo hysteroscopic myomectomy. Any fibroids located within the uterine wall cannot be removed using this technique. During this outpatient procedure, you are put to sleep. The scope is passed up the vagina and through the cervix. Fluid is injected into the uterine cavity to lift apart the walls. Small instruments can be passed through the scope to shave off the tiny fibroids. We recommend that you rest for a few days. Expect mild cramping and light bleeding after the procedure, but these symptoms subside within a few weeks.

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