Myomectomy (Fibroid Treatment)

A myomectomy is a surgical procedure performed to remove a non-cancerous tumor called a fibroid, also known as a myoma. These growths develop within the uterus.
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Overview

What is a myomectomy?

A myomectomy is a surgical procedure aimed at removing a non-cancerous tumor known as a fibroid or myoma, which typically develops within the uterus. Myomectomy is primarily recommended to women who wish to preserve their fertility. Fibroids can give rise to various symptoms such as painful and heavy menstrual periods, frequent urination, lower abdominal discomfort, and fertility issues. By performing a myomectomy, these symptoms can be addressed and alleviated.

What are fibroids?

Fibroids are non-cancerous growths that originate from the uterine tissue.

Fibroids are quite common, affecting approximately one in three women at some point in their lives. They are more frequently observed in women of childbearing age who have not had children. Certain ethnic groups, such as Afro-Caribbean women, may have a higher susceptibility to developing fibroids.

These growths are influenced by oestrogen levels, and their size can increase during pregnancy or decrease after menopause due to hormonal changes.
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How is myomectomy performed?

Myomectomies can be performed using two approaches: open myomectomy and laparoscopic myomectomy, also known as keyhole surgery.

Open Surgery for Fibroids:

Typically performed under general anesthesia, an open myomectomy involves making one large incision either across the bikini line or vertically down the abdomen. Additional incisions may be made if required based on the size or number of fibroids.

After accessing the uterus through the incision, the fibroids are surgically removed. To minimize blood loss, a drug may be injected into the fibroid or a tourniquet may be applied to cut off blood supply. Once the fibroids are removed, the incision is closed with stitches or staples, completing the procedure.

Laparoscopic Myomectomies:

In some cases, you may be offered a laparoscopic (keyhole) myomectomy. This involves your surgeon making small incisions through which specially designed tools are inserted to perform the operation without a large incision.

Laparoscopic myomectomy may have a shorter recovery time compared to an open myomectomy. However, it may not be suitable for everyone, so it's important to discuss with your consultant whether it's the appropriate treatment for you.

Both laparoscopic and hysteroscopic myomectomies carry their own risks, which your consultant can explain in greater detail if necessary.
Jason Yap - Consultant Gynaecologist
Consultant Gynaecologist, Gynaecological Oncologist & Lead Clinician for Vulval Disease
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Recovery

Myomectomies are major surgical procedures that are typically performed under general anesthesia. Therefore, it is important to be prepared for a hospital stay of a few days, during which a dedicated team of nurses will provide post-operative care.

During your recovery from surgery, a catheter will be inserted as you may not be able to get up to use the restroom immediately. This is due to the use of a spinal injection alongside general anesthesia to manage post-operative pain. The catheter is usually removed the following day, and the nursing staff will assist you in getting up and walking again.

Once you can independently urinate, have your pain under control, and are able to eat and drink, you will be discharged from the hospital and allowed to return home. This typically takes a few days.

The recovery period before returning to work can range from six to eight weeks, depending on the nature of your job. This timeline also aligns with your follow-up appointment, during which your consultant will assess your recovery progress. Your consultant may advise against lifting heavy objects for 12 weeks to allow your body to fully recover from the surgery.

Regarding driving, it is generally recommended to wait at least four weeks before resuming driving. It is best to consult with your consultant and also check with your insurance company for any specific guidelines or requirements.