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Myomectomy: Procedure, recovery, and complications

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With the increasing number of cases of infertility, medical community has been diverting a lot of research and innovation to find suitable options for women, men and couples to deal with it. Nowadays, there are many treatment options available for infertility in a woman. One such common surgical treatment is myomectomy. 

Also known as fibroidectomy, this procedure removes uterine fibroids or leiomyomas surgically, preserving the uterus and reproductive potential. 

Uterine fibroids are a common condition that affects fertility in women. It is the growth of noncancerous tumours inside or on the walls of the uterus.

One benefit of myomectomy is that it preserves your fertility. Because this surgery removes the fibroids and not the uterus, therefore,  you can still get pregnant again. 

Before undergoing myomectomy surgery, you should know what to expect and how to prepare for it. In this article, we are going to discuss myomectomy procedure, recovery and possible complications. 

What Is Myomectomy?

In simple words, myomectomy is a common surgical procedure in which the uterine fibroids are removed from your uterus. There are two types of myomectomy, Laparoscopic and Robotic
Laparoscopic myomectomy uses a small abdominal incision and a thin camera. 

Robotic myomectomy uses a separate console to control the instruments. Robotic myomectomy is more expensive and involves a longer hospital stay. The difference is small. Robotic myomectomy involves a larger incision, and a laparotomy is performed when the fibroid is large and can no longer be removed through laparoscopic methods.

Most women recover from a myomectomy within two to four weeks. They aren’t advised to lift heavy objects or exercise for six weeks, but they can return to work after this time. The recovery period varies between women, with abdominal myomectomy taking the longest. 

What Is Myomectomy Surgery?

Myomectomy surgery is an option for women who want to remove fibroids from the uterus and are experiencing uncomfortable symptoms. This surgical procedure removes the fibroids and preserves the surrounding tissue.

The risks and benefits of this procedure vary with each type. Your doctor will discuss the risks and benefits of the surgery with you and help you decide whether the procedure is right for you. This procedure may be right for you if you have been experiencing symptoms of a fibroid tumour and haven’t been able to conceive.

The most common type of myomectomy surgery is abdominal. This procedure involves an incision in the lower abdomen and removal of the fibroids. Your doctor may recommend a different type of surgery if the one you’re considering is too large or too small.

About Myomectomy Procedure

Myomectomy surgery is performed through incisions that are small enough to be seen through a laparoscope. Your doctor will use a surgical instrument called a laparoscope to remove the fibroids. A small incision is closed with sutures after the procedure. 

Before starting the procedure, the doctor will need general anaesthesia to prevent any pain and discomfort. Myomectomy procedure will be performed in different ways depending on the size, number and location of fibroids. Here are the different ways in which myomectomy procedure is performed. 

  • Abdominal Myomectomy

Abdominal myomectomy procedures are performed through a horizontal or vertical incision made in the abdominal wall. The surgeon can use traditional surgical instruments and techniques to remove the fibroids. The procedure can be performed under general anaesthesia and usually requires a single night’s stay in the hospital. This procedure is often performed on patients with thin abdomens who are not at risk for severe scarring. 

  • Laparoscopic Myomectomy

Laparoscopic myomectomy is a surgical procedure for the removal of fibroids. Typically, this surgery is performed on fibroids that are less than 10 cm in diameter but can be performed on larger or more numerous fibroids. It is an alternative to hysterectomy for women who would like to keep their uterus and have children. There are some contraindications to this surgery. The risks associated with this surgery include infection, bleeding, and risk of pregnancy. Women should notify their doctors if they are planning to become pregnant before undergoing a laparoscopic myomectomy. 

  • Hysteroscopic Myomectomy

Hysteroscopic myomectomy is a surgical procedure to remove fibroids or polyps from the uterus. The procedure is usually performed as an outpatient procedure. However, in some cases, you may need to stay overnight. In the first few days after the procedure, you will experience minor pain and discomfort. A lighted camera will be inserted through the vagina and directed up to the uterus. The surgeon will then inject sterile saline into the uterus, expanding it to remove the fibroid tissue. This fluid is then disposed of, and the hysteroscopic myomectomy is complete.

  • Robotic Myomectomy

A robotic myomectomy is a surgical procedure used to remove uterine fibroids. During the procedure, the physician uses the da Vinci(r) surgical system to remove the fibroids through five tiny incisions. The robotic arms are operated by the surgeon from a console. The surgeon is completely in control of the robot during the entire procedure. Although conservative treatments are always recommended first, a robotic myomectomy can be a good option for some women. Although the procedure is generally performed as an outpatient procedure, there are still some risks involved.

Recovery from Myomectomy

After your myomectomy, you will be shifted to the surgical ward. You will be required to stop all medications for at least 8 hours prior to the surgery. If you are having an abdominal myomectomy, you should stop drinking and eating for at least eight hours before the procedure.  

It takes 1 to 2 days to recover from the surgery. However, you still have to reduce all the other activities for 4 weeks. After 6 to 8 weeks of the surgery, you can resume back to your old life. 

You will also be asked to stop taking any other medicines. In the morning, you will be asked to drink only water and follow your doctor’s instructions. You will be monitored for a few hours before being discharged.

Physical activity can resume immediately after the myomectomy, although you will need to avoid heavy lifting or strenuous exercises for several weeks. Also, you should avoid pregnancy for at least three to six months after the procedure. 

Once the incisions have healed, you can resume normal activities such as swimming, walking, and other activities. After the surgery, you can return to work after two to six weeks. Be sure to consult with your doctor if you experience severe pain or have unusual bleeding. You have to stay one to two nights in the hospital before you get discharged. 

Potential Complications of Myomectomy

After your myomectomy, your body will experience some changes. Although rare, your uterus will no longer be able to stretch fully and you will experience bleeding, cramping, and pain after the operation. Potential complications of myomectomy are described below. 

  • Bleeding
  • Injury to the uterus or uterine perforation
  • Injury to other organs
  • Infection
  • Incomplete removal of fibroids
  • Venous or embolism
  • Pooling of blood in the outer layer of the uterus

How to Get Pregnant Fast after Myomectomy?

If you have had a myomectomy, you may wonder how to get pregnant fast. While you might want to conceive as quickly as possible, you’ll probably have to wait a few months for your period to begin again. The good news is that getting pregnant after surgery is possible. 

To improve your chances of getting pregnant after a myomectomy, follow your doctor’s instructions. After the surgery, you’ll likely be given pain medication and prescribed a diet rich in fibre. The recovery process for a myomectomy can take anywhere from three to six months. A fertility specialist will prescribe you a specific treatment plan based on your symptoms and your health. For best results, try to conceive as early as three to six months after the surgery.

Although myomectomy is a safe and effective procedure, it does carry some risks. Women with fibroids should inform their doctors before trying to get pregnant. The risks of miscarriage and vaginal bleeding can be reduced by taking medications that boost your blood count. Your doctor may suggest ways to boost your blood count before undergoing surgery.

Conclusion

A myomectomy is an effective treatment for uterine fibroids. It helps to remove fibroids from the uterus and increase your chances of conception. If you are having trouble getting pregnant due to fibroids, you can consult a doctor about this treatment. Depending on the size, number and location of the tumor, the doctor will perform different types of myomectomy surgery. The procedure is simple, but it may take a few weeks for recovery.

Frequently Asked Questions

How Fast Do Fibroids Grow Back After Myomectomy?

If you’re considering a myomectomy to remove a fibroid, you’re likely to be concerned about how fast fibroids grow back. While 90% of women who undergo surgery experience major improvement, and many no longer have symptoms, the fact remains that 20% of women experience fibroids growing back within the first few years. This means that your surgeon might have missed some fibroids or removed them too early, which may result in future recurrences of symptoms or additional surgeries.

How to Get a Flat Stomach After Myomectomy?

Following a myomectomy, a woman may be left with a drooping belly. The most effective way to address this issue is through exercise. The abdominal muscles have 8 layers, including the skin, fascia, and muscles. These muscles are essential for maintaining a flat stomach and minimizing the “abdominal pouch.” To achieve a flat stomach after a myomectomy, you must follow a healthy eating and exercise regimen. Aim to get at least 20 minutes of aerobic exercise a day.

Is Myomectomy Painless?

The procedure isn’t always painless, and it’s a good idea to know what to expect before the procedure. You will not feel any pain during the surgery due to general anesthesia. However, patients might feel mild cramping that can be managed with over-the-counter pain medication. 

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