A myomectomy is a surgical procedure to remove uterine fibroids. Compared to a hysterectomy, which removes your entire uterus, a myomectomy removes only the fibroids; leaving the uterus intact.
After a myomectomy, patients often report a reduction in heavy menstrual bleeding and less pressure on the pelvic.
Why should I opt for a myomectomy instead of a hysterectomy if I need to remove uterine fibroids?
- You plan to have children in the future
- Your gynaecologist suspects that fibroids are affecting your fertility
- You wish to keep your uterus
What should I take note of if I opt for a myomectomy?
While a myomectomy can remove fibroids, there is a possibility that they can regrow. Younger patients and those who have been diagnosed with higher volumes of fibroids than usual, are at risk of redeveloping the condition. Women who are nearing menopause have a lower chance of having recurring problems from fibroids after a myomectomy.
Your gynaecologist may perform an abdominal myomectomy, a laparoscopic myomectomy, or a hysteroscopic myomectomy.
Abdominal myomectomy (Open myomectomy)
During an abdominal myomectomy, an incision is made on the lower abdomen to remove the fibroids from the wall of the uterus. The uterine muscle is then stitched up. You will be under general anaesthesia during the procedure.
Most patients would spend two nights’ stay in the hospital for observation and around four to six weeks of recovery at home. You will have a four-inch horizontal scar near your bikini line.
Patients who intend to have a baby after the procedure may have to opt for a Caesarean section (C-section) to reduce the chance of their uterus rupturing during labour.
Laparoscopic myomectomy is used to remove smaller fibroids. Your gynaecologist will make three or four one-centimetre incisions at the belly button, below the bikini line and near the hips. A thin laparoscope will be placed through an incision, allowing your gynaecologist to see the ovaries, fallopian tubes and uterus. Surgical instruments will be inserted through the incisions to remove the fibroids before your uterine muscle is sewn back together.
Most patients spend one night in the hospital and require around two to four weeks of home recovery. You will have small scars at the locations where the incisions were made.
You can opt for hysteroscopic myomectomy if you have submucosal fibroids. If the fibroids are located within the uterine wall, you will not be able to opt for hysteroscopic myomectomy.
During the procedure, a speculum is placed in the vagina and a hysteroscope will also be placed through the cervix into the uterine cavity. Fluid is used to lift apart the walls and surgical instruments will then pass through the hysteroscope to shave off the submucosal fibroids.
Hysteroscopic myomectomy is an outpatient surgical procedure. You will be able to return home after a few hours of observation.
After the procedure, some patients may experience cramps and light bleeding. Patients are advised to rest at home for at least one to four days. There will not be any scar after the procedure.
Reviewed by Dr Karolyn Goh, Specialist in Obstetrics and Gynaecology, and Consultant of Raffles Women’s Centre.
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