During the myomectomy surgery, the doctor can effectively remove the myomas (fibroids) without actually damaging the uterus. Therefore, once the myomectomy is done, the uterus can typically maintain regular functions, which means that the woman can conceive later on. Myomectomy surgery is one of the Advanced OBGYN in-hospital procedures, meaning that it requires the patient to stay at the hospital for a short while before they’re ready to continue the recovery process at home. Keep on reading if you wish to learn more about myomectomy and the different types of this procedure.

What Is Myomectomy?

As mentioned, myomectomy surgery involves uterine fibroids removal. This surgery is often suggested when the patient experiences the following symptoms due to fibroids:

  • Irregular menstrual bleeding
  • Very heavy periods
  • Pain in the pelvic area
  • Frequent need to urinate

If you find that you have the same symptoms, don’t hesitate to get in touch with Dr. Kompal Gadh, an experienced OBGYN specialist at the Advanced OBGYN Institute.

There are three different ways to perform a myomectomy, namely abdominal, laparoscopic, and hysteroscopic myomectomy. During abdominal myomectomy, the doctor removes the fibroids through the incision made in the lower abdomen. Laparoscopic myomectomy is less invasive, and the fibroids are removed through several small cuts, which is typically performed robotically. In the case of hysteroscopic myomectomy, the doctor removes the fibroids through the vagina and cervix by using a special scope.

Hysterectomy is a procedure that completely removes the uterus, while myomectomy leaves the uterus intact, meaning that the woman can get pregnant in the future. An abdominal myomectomy is a good option for very large fibroids that are also greater in number. Laparoscopic myomectomy is better suited for cases when there aren’t too many fibroids, and they’re smaller. Finally, hysteroscopic myomectomy is often suggested for the removal of smaller fibroids inside the uterus.

What Is the Procedure Like?

Process of Gynecological Surgery Operation Using Laparoscopic Equipment.

Depending on the type of myomectomy performed, the procedure will also differ.

Abdominal Myomectomy

General anesthesia will have to be administered. The doctor makes an incision that starts at the lower abdomen and reaches the uterus. Through this incision, the doctor will remove the fibroids and then proceed to close the wound with stitches. This type of myomectomy requires a one- to three-day stay at the hospital.

Laparoscopic Myomectomy

Once the patient is fully under the effect of general anesthesia, the doctor makes four small cuts in the lower abdomen. Carbon dioxide gas is used to fill the stomach so the doctor can get a better visual inside the abdomen. A lighted, thin tube with a camera on top called a laparoscope will be inserted into one cut while other special tools will be inserted into others. In the case of a robotic procedure, the doctor controls the tools with a robotic arm. Once the fibroids are removed, the doctor will release the gas from the abdomen, remove the tools, and stitch up the wounds. This particular type of myomectomy often warrants an overnight stay at the hospital.

Hysteroscopic Myomectomy

This particular procedure can either be done under general or local anesthesia. The doctor gets a special liquid inside the uterus to make it wider and see the fibroids better. They then use a lighted scope and a wire loop through the vagina and cervix to shave off fibroid pieces in the uterus. Once the liquid is removed, it also gets rid of any fibroid remnants. In general, most women can go home on the day of the surgery.

Myomectomy Recovery Process

After the surgery, it’s perfectly normal to feel some pain and discomfort. Spotting could last anywhere between a few days and a few weeks as well. The doctor will prescribe pain relievers that are safe to take during the myomectomy recovery period.

Depending on the type of fibroid removal surgery, when you’ll be able to go back to regular daily activities will vary. For instance, abdominal myomectomy recovery time usually takes the longest, from four to six weeks. The laparoscopic myomectomy recovery period is anywhere between two and four weeks. On the other hand, hysteroscopic myomectomy has the shortest recovery period of just two to three days.

Make sure to wait for the incisions to heal completely before you start more strenuous physical activity again. Also, discuss with your doctor when is the safest time to engage in sexual intercourse again; it might be necessary to wait for about six weeks to do so.

As stated before, it’s possible to get pregnant after a myomectomy, but depending on the type of myomectomy, you’ll have to wait for the uterus to heal before you start trying to conceive. In general, you might have to wait anywhere between three and six months.

Potential Risks and Complications

It’s rather rare to have any complications after going through a myomectomy, but there are some risks involved, just like with any surgery, such as:

  • Excessive bleeding
  • Infection
  • Organ damage in the surrounding area
  • Uterus perforation
  • Scar tissue that could affect fertility
  • New fibroids that warrant another kind of removal

In case you notice any of the following symptoms after the procedure is done, make sure to call your doctor:

  • Breathing difficulties
  • Fever
  • Heavy bleeding
  • Severe pain

The Scarring After the Procedure

Female Patient With Doctor Gynecologist Gynecology Consultation in Medical Clinic

In the case of abdominal myomectomy, the scar will be located below the pubic hair line, often hidden by underwear. While it won’t disappear completely, it will fade gradually. It’s also possible to feel tenderness or even numbness where your scar is for a couple of months after the procedure.

When scars from laparoscopic myomectomy are concerned, they will be considerably smaller and less pronounced. They will also gradually fade out. These might be visible when wearing a crop top or a low-cut bikini.

The Effect on Future Pregnancies

Myomectomy doesn’t damage the uterus, which technically makes it possible for the woman to get pregnant after the procedure. However, it can weaken the uterus, which could lead to certain complications during pregnancy and labor. To combat this problem, the doctor typically schedules a C-section just before the due date. Sometimes, it’s even possible to perform the C-section through the myomectomy incision to minimize the number of scars.

In general, it’s possible to get pregnant after a myomectomy, but women who had six or fewer fibroids removed have more chances to get pregnant than those who had more than that.

Myomectomy is an effective procedure for fibroid removal and associated symptom relief. Which type of procedure one may need will depend on the number and size of the fibroids. Uterine fibroids don’t have to be a reason for concern, especially in regards to future pregnancies, if you act in a timely manner and get the treatment you need. That said, if you find yourself having any unusual symptoms or simply wish to maintain good gynecological health, don’t hesitate to get in touch with us at Advanced OBGYN Institute. You can count on our experienced and compassionate physicians to take good care of you.